Saturday, December 11, 2010

WE'RE HOME!!!

We are all home now. Isabella hasn't felt like doing much so we're just going to lounge around and watch TV. We have a follow up appointment on Wednesday and we'll start doing blood checks to watch her blood counts.
 
Here are a couple pictures from the hospital.
 
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Looney Lenny visits Isabella in the playroom.

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Daddy and Isabella take a nap.P1030895

Isabella reads cards that her classmates made for her.

Thursday, December 9, 2010

Almost Done with Chemo

So it's been a pretty rough week with Isabella in the hospital. Thankfully, Isabella hasn't had as much nausea as she had in previous cycles (although it was a little worse today). Actually, the worst part has been her frequent urination. Because of some of the toxic effects of the chemo on Isabella's other organs, they are also hydrating her with a lot of IV fluids. They are giving her so much fluid that she has to go to the bathroom every hour or so, which really makes getting any sleep tough on everyone. So the lack of eating plus the lack of sleep has made Isabella really weak (which in turn has been very difficult for Julianne and me to deal with).

Isabella did have a nice pick-me-up yesterday, when two of her teachers from school came to visit her. They brought her a bunch of gifts and activities and also some cards that her classmates made for her. Isabella was very excited to see them as she gave them a tour of the pediatric floor and played games with them in the playroom. That was certainly the highlight of her week.

Well thankfully we're almost done at the hospital. Friday will be the last day of chemo and we're looking forward to being discharged on Saturday. We don't have much planned going forward and don't know what we're doing for Christmas yet. We're just planning on staying home for the next couple of weeks and hoping that Isabella doesn't develop a fever. Since we expect her white cell count to drop significantly, her immune system will be severely compromised, so if she does develop an infection, we'll need to go back to the hospital for at least another week. Our doctor has told us that we should expect her blood counts to bottom out right before Christmas, so we really don't want to take a chance that we'll be in the hospital for Christmas, so we're going to keep visits to a minimum.

Monday, December 6, 2010

A Sad Day of Remembering

Isabella just completed the first day of chemo.  Not much to report yet.  Hopefully, we'll be out of here on Saturday.

The last time we were in the NYU Pediatric Unit was on June 5, 2009, about a year and a half ago.  On that day, we headed home after Isabella completed her recovery from a stem cell transplant.  We were hoping to never have to return here.  As we walked into the unit, we were immediately flooded with emotion as we went through all the routines of hospital admission and treatment.  Overall it's a sad day as we remembered a lot of things we were hoping to forget:
  • ...remembering all the nurses, nurse assistants, maintenance crew, and even the lunch ladies and having them remember Isabella
  • ...remembering how horrible the elevator banks are at NYU (hint:  during peak times, jump on an available elevator no matter what direction it's heading.  If you wait until it comes back, chances are it'll be full.)
  • ...remembering you can save time and keep warm if you're heading uptown by using the Rusk entrance instead of the NYU main entrance (and you can visit the botanical garden on the way)
  • ...watching Isabella instinctively offer her arm to have her blood pressure checked and remembering to hold her own shirt up as the nurse checks on her mediport
  • ...packing shorts and t-shirts knowing how hot it is in the rooms
  • ...remembering that the rooms are so dry that we used to lay wet towels over the radiators to get some moisture in the air
  • ...remembering how awful the wifi connection is at the hospital because it kicks you off every few minutes and you have to reconnect
  • ...remembering all the items that I used to "spy" as we played I Spy when we walked around the unit
  • ...remembering the hopscotch drawn on the floor and how Isabella used to play on it.  She can no longer play hopscotch because her right leg is so weak.
  • ...knowing how to work the IV unit
  • ...remembering that the DVD Library has odd hours so rushing there as soon as they announced they were open (today, they were opened from 7:30 to 7:45)
  • ...remembering how crappy it is to not have the window side of the room
And that was just after being here a few hours.  I'm sure we'll hit a few more before Saturday.

More Chemo This Week

On Monday, we will head into the City to start a second round of chemo.  This round will consist of a different set of drugs than the first round and will consist of higher dosages.  Because of that, the chemo needs to be administered in the hospital and we will be staying there for the next few days.   Hopefully, we’ll be back home by the weekend, and with any luck, Isabella will be done with any nausea or fevers before Christmas.

Speaking of Christmas, we put up our tree today.  Here are a couple pictures from the weekend.  Enjoy, and wish us luck for the week!

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Tuesday, November 30, 2010

Post Thanksgiving Update

We enjoyed a very nice Thanksgiving dinner over my mom’s house with friends and family.  On Saturday, Isabella had another MRI, and unfortunately, it shows that the tumor continues to grow.  We were expecting this because we have noticed she is weaker in general, although we were hoping for at least a stable scan.

We will be talking with our oncologist to start the next round of chemo asap.  This round will be a higher dose and with different drugs which will hopefully have some effect.  Isabella seemed to tolerate the last round really well, as she had very little nausea symptoms and her blood counts never really bottomed out.  Her hair has started falling out, but aside from her hair looking a little thinner, you couldn’t tell just by looking at her.  We expect it to all fall out with the next round.

Wednesday, November 17, 2010

Two Years Later

It’s hard to believe it was two years ago when we started this journey, when Isabella was diagnosed with brain cancer.  Part of me remembers it like it was yesterday, yet, part of me feels like we’ve been living like this for a million years.  Unfortunately, because of Isabella’s recurrence, this anniversary is a lot more somber than last year’s.  Last year, we had much more hope to cling to, and you can tell if you read that post (“One Year Later”).  Now, we just go from day to day – our long term outlook is now just mere weeks instead of years.  I would be ecstatic if I were able to write a “Three Years Later” and a “Four Years Later” post, but we don’t look that far ahead.  Right now, we’re treating Isabella as best we can and for as long as we can.

I know a bunch of people jumped on board this blog sometime in the middle of our journey.  For those of you, I recommend reading the first couple of weeks of post which narrate some of the events we went through in those first harrowing days.  As always, you can see all the archived posts along the left side.

The First Week (11/16/08 to 11/23/08)

The Second Week (11/23/08 to 11/30/08)

As far as upcoming treatment, we’re still not sure what’s next. We know there will be an MRI, then potentially another round of chemo, although we’re not quite sure which cocktail of chemo this time.

Other than that, we’re looking forward to this holiday season. Smile

Monday, November 15, 2010

Quick Update

So it’s been over a week since Isabella got her chemo.  Fortunately, she hasn’t developed any side effects yet.  Her appetite has been fine and she’s had no nausea and her blood counts are still good, so we don’t need any transfusions.  Isabella has been going to school regularly as well.  Early in the week, she was a little weak, but improved over the course of the week.  If her hair is going to fall out, it usually takes a few more weeks.

So that’s it for now.  Not much else to report until the next round of chemo, which should be in a couple more weeks.

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Sunday, November 7, 2010

So Far, So Good

Well, so far, Isabella has been doing really well.  She hasn’t had any nausea yet, and she’s been eating pretty well.  Yesterday and today, we played a little baseball and today, we hung out at the mall for a couple hours and bought her a bunch of new clothes.  Isabella is feeling so good, in fact, that she wants to go to school tomorrow.  So we’re going to see how that goes, but we’re going to hang out close to home just in case she runs out of steam early and we have to bring her home.  She’ll also have a blood draw tomorrow to see how fast her blood counts are dropping so we’ll get an idea of when and if she’ll need a transfusion.

So, I’m gonna keep this brief, and hopefully, Isabella’s side effects remain nil.

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Can you guess Isabella’s favorite color?

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Look out, Grandma!

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Grandpa being taken for a ride.

Friday, November 5, 2010

Done With the Chemo, For Now

So Isabella finished up the second day of chemo uneventfully.  Now we play the nervous waiting game.  We’ll monitor her closely for nausea and fevers, although we don’t expect the nausea to hit for a couple more days.  She has been ok so far and has been eating with no problems. 

On Monday, we’ll do our first of several blood draws that will check her blood counts to see when she will need transfusions. 

Since we don’t know how Isabella will react to the chemo, we don’t have any plans for the weekend (or for the next few weeks for that matter).  We’re just going to sit around home and take it easy, and maybe catch up on some movies.  Also, her hair probably won’t fall out for a couple of weeks, which we’ll be sad to see.P1030546

Wednesday, November 3, 2010

Here We Go Again

So we officially start up chemotherapy again tomorrow, Thursday, November 4.  Our oncologist has put together different drugs for a custom treatment plan for Isabella.  There is no protocol anymore – at this point, we’re just trying anything in hopes of trying to contain this thing.  Right now, we have two cycles of chemotherapy planned.  For the first one, she’ll receive two drugs over the course of two days.  We’ll then monitor her blood counts, and over the course of the next three weeks, she’ll probably require some blood transfusions.  With low blood counts, Isabella will be susceptible to infections, so we’ll also be watching out for fevers – if she suddenly develops a fever, we will need to be admitted to the hospital for antibiotics for 10 days.

In about a month,  we’ll try two different drugs for the second cycle.  The theory behind this approach is that since these drugs work in different ways, if we attach the tumors from different angles, we have a better chance at some sort of response.  Shortly after the second cycle, we’ll do another MRI and see if there is any response and either try something else or do more of the same.  At this point, we’re not looking past that next scan.

Isabella did well with the chemotherapy last time.  She tolerated it fairly well and the tumor responded well.  We’re hoping that it’s the same this time around.

Thanks to everyone for your support and well wishes.

Sunday, October 31, 2010

Happy Halloween Weekend

As promised, we had a great Halloween weekend.  On Friday night, the kids had a Halloween dance at their school.  On Saturday, we went for a nice walk through the New Canaan Nature Center discovery trails.  On Sunday, before the the trick-or-treating festivities, we played in some leaf piles.  As they say, pictures are worth a thousand words, so we have a few thousand words below!

(Click on each picture to see a larger view!)

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Saturday, October 30, 2010

More Scans, More Answers

So I mentioned in the last post that Dr. Wolff (from Tufts and previously from MD Anderson) did not rule out radiation scarring in Isabella’s brain.  MRIs are open to interpretation and does not distinguish readily between tumor and scarring.  Based on some of Isabella’s clinical symptoms, there was still a possibility that this wasn’t tumor.  Julianne found a study being done at the National Institutes of Health (NIH) in Bethesda, MD, where they were doing a special MRI (with spectroscopy) which looked at other characteristics in the brain.  The study is to see whether this MRI with spectroscopy can provide more insight into whether a suspect area is tumor or scarring.

We drove down to Bethesda this week to take part in the study in hopes that the more detailed MRI would put to rest what is inside Isabella’s head.  Unfortunately, we did not receive the answers we were looking for.

Based on the scan results, the doctor is certain that the lesions are indeed tumor.  Also, based on some of the measurements, they showed that the tumor has grown and that it appears to be highly aggressive.  The worst part is that the scan showed two new spots on Isabella’s right side of her brain.  It is extremely uncommon for tumors to “cross hemispheres”, so the doctors suspect that tumor cells broke off, traveled through the spinal fluid to the other side.  We are scheduling a spinal MRI next week, but this new piece of information is extremely troubling.

Also, we have been in touch with a neurosurgeon at Robert Wood Johnson Hospital in New Jersey, where they have one of the MRI guided laser treatment machines that I’ve written about in the past.  These laser machines are able to treat tumors that were previously considered inoperable.  However, these laser treatments are more suited to tumors that are in chunks (focal), as opposed to tumor cells that are more spread out over an area (diffuse).  We met with the doctor yesterday on our way back from Maryland, and unfortunately, since Isabella’s tumor has some diffuse components, he does not consider her a candidate for the laser surgery.

If there is anything positive to gain from this new information is that the new lesions found on the right side appear to be focal and in an area that may be resectable.  One of the other treatment options that we spoke about previously is immunotherapy (or vaccine treatments).  But in order to create the vaccine, you needed a certain amount of tumor and Isabella’s was not resectable at the time.  We are now discussing with our oncologist to see if we can verify that the new tumors are resectable, and if so, we would like to collect it for use in a vaccine.  I should also mention that the vaccine would most likely not “cure” the cancer at this point, but possibly only extend survival.

So, to summarize everything, here is where we are.  Our only option at this point is chemotherapy, and we will be looking to start chemotherapy very soon, possibly next week, following a spinal MRI.  However, before we start, we would like to resect the new tumors if possible to be used for immunotherapy.  One downside to surgery to resect the tumor is that it would delay chemotherapy further, from a few days, to possibly a few weeks.

In the meantime, we plan on enjoying the upcoming Halloween.  We’ve already bought Isabella some special, no sugar, candy that she will be able to eat on Halloween.

Thanks again for keeping up with us through this difficult time.

Wednesday, October 27, 2010

Back Where We Started

So over the last two years, Julianne has been scouring the Internet for any and all treatment options for Isabella.  As I’ve written, her tumor is extremely rare and very few people have worked with it before.  Just to show how rare, she only found one case study that referenced her particular tumor type where the patient responded to chemotherapy, even after recurrence.

As we got the news of Isabella’s recurrence, we have been working with our oncologist on different types of chemo treatments that we can try (informally, they’re called cocktails as they mix and match several types of chemotherapy to see what gets the best response).  Of course, we brought up that case study for the single patient and our oncologist informed us that she knew the doctor that worked on that case study and that he had just moved to Tufts Medical Center in Boston.  We contacted him and he agreed to see us and look at Isabella’s case.

We met with him for a couple hours two weeks ago where we basically went through our entire history of treatment and he briefly looked at the latest scans.  The good news is that he still hasn’t ruled out radiation necrosis.  We also spoke about what our options are if it is decided that it is tumor.  He mentioned that although Isabella’s tumor type may be rare, it appears to be of a type that responds to chemo, even after recurrence.  So we were inspired that we should never give up when treating this tumor.

So here we are, more than three months after a routine follow up MRI showed some new areas of concern in Isabella’s head.  Back then, we weren’t sure if it was tumor or radiation changes, and today, we’re still not sure.  We still don’t have a treatment

Sunday, October 24, 2010

New Additions to the Family

We recently bought two new pets for the kids, sugar gliders, also known as sugar bears.  These cute little furry animals are part of the marsupial family and come all the way from Australia.  The attractive features they bring as pets are that they are clean, friendly, and need relatively little maintenance.  We’ve had them for about a week now and are still going through the bonding phase, and we think they are getting a little more used to us now. 

Here are a couple pictures and videos of “Oriette” and “Squeeky”, our new sugar gliders.  (FYI, Annalise wanted to name hers Oreo because it was black and white, but since it is a girl, she wanted the name to be more feminine, hence, Oriette!)

Click each picture for a larger view.

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Monday, October 11, 2010

Prayers for Another Child

Shortly after Isabella was diagnosed with her cancer, one of our neighbor’s children, who also happened to be in Isabella’s class, was also diagnosed with cancer – this one leukemia.  He went through his treatment and was showing that he was clear until his last scan, which showed his cancer had returned.  He will now require further treatment and probably a bone marrow transplant.  If none of his family members match, they will need to find a match in the national registry to find a matching donor.

If you haven’t already, I urge you to register to become a donor.  They will send you a kit, where all you need to do is swab your cheek and mail it back to them.  There are some restrictions to be eligible to be a donor, so if you don’t qualify, you can contribute monetarily (it costs $65 to process registrations).

You can register or get more information here:

http://www.dkmsamericas.org/bone-marrow-donors

Sunday, October 10, 2010

Fall Fun–10/10/10

Here are a couple recent pictures showing some fun that we’ve been having.  Enjoy!

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The kids try out this tractor during our visit to the Norwalk Department of Public Works.P1030428

Another picture of the kids at the Norwalk DPW.

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Roneil getting ready for the first game of the Yankees playoffs.  He’s wearing his Yankees hat, shirt, jacket, snuggie, foam finger, shopping bag, and coffee mug.

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Annalise is pretty upset that all the Yankees ice cream is gone! Sad smile

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The kids had their own sleepover party last night.

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Isabella shows off a new hand-made shawl from a friend.

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The kids enjoy treats from apple picking.  We actually brought a portable scale to the orchard so that we can weigh the apple that Isabella ate.  (By the way, the apple Isabella ate was 104g and 12g of carbs.)P1030476

From the odd and bizarre file.  This half eaten apple was still on the tree!

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The kids pick out their pumpkin to prepare for Halloween.

Friday, October 8, 2010

Nervous Wrecks

We haven’t had many medical updates recently because frankly, there hasn’t been much to report.  Since it’s been awhile, let me take a minute to review where we are.

In mid-July, a routine follow-up MRI showed areas of concern in Isabella’s brain which immediately gave us reason to worry that Isabella’s cancer had returned.  Our doctors were split on whether this was recurrent tumor or changes due to radiation, so they suggested we do another MRI a month later.  Also in the meantime, we sent out several requests for second opinions.

The wait for the next MRI was very difficult for us because Isabella exhibited many symptoms that the tumor was indeed affecting her.  Her right hand and foot progressively got weaker and her mental functions degraded as well – she found it difficult to talk and put sentences together.  The MRI showed that the spot grew slightly and we worked with her oncologist to develop treatment options.  We were also still waiting for responses for second opinions so we stayed in a holding pattern.

While we waited for a treatment plan, we put Isabella on a modified Atkins diet.  Almost immediately, we noticed that Isabella’s symptoms stopped getting worse and in some cases, such as her mental function, actually improved over time.  She seemed to have plateaued, which gave us a little bit of relief.

Isabella also has been loving going to school.  At first, we were concerned how she we do physically, but the school has been very accommodating in assisting Isabella.  At the beginning of September, she was deteriorating so fast, we thought that she would need a wheelchair.  But fortunately, she improved physically and has been able to walk on her own.  We were also worried because all of her friends from last year went to different classrooms, but Isabella, with her magnetic personality, had no problems making new friends.

This past Tuesday, almost three months after the spot was first detected, Isabella had another MRI.  We were hopeful that since Isabella’s symptoms stopped getting worse, perhaps the tumor had stopped growing.  But unfortunately, the results showed that the spot had grown again, albeit slightly, but it did grow, and our doctor believes that we should start treatment as soon as possible. 

Over the last few weeks, I described some new and innovative treatment options for brain tumors, but unfortunately, few of them are mature enough for Isabella.  Ideally, if we had all the time in the world, we could somehow keep the tumor in check, and let these other technologies develop an alternate treatment or even a cure.

Our doctor has recommended a couple chemotherapy options, which we are currently evaluating.  Although we’re not looking forward to the side effects of chemo and the hospital stays, we are hopeful that the tumor responds to the chemo positively as it did last year.  Again, we’re trying to buy time here in the hopes that something, anything pans out – whether it’s a vaccine or a laser or a magnetic helmet.

Thursday, September 30, 2010

Cancer Awareness Month Reviewed

So here we are at the end of September and the end of Pediatric Cancer Awareness Month (and Prostate Cancer Awareness Month, Ovarian Cancer Awareness Month, and National Sewing Month).  I hope that I’ve helped bring at least a little bit more awareness to this horrible disease that affects not just mine, but thousands of other families across the country.  What have we learned?

  • Every day, 10 children will be diagnosed with a brain tumor while 3 more children will die.
  • Many of the symptoms of brain tumors are common ailments that can be misdiagnosed very easily.
  • Pediatric cancer research funding is woefully underfunded compared to other cancers, especially at large, well known organizations, such as the American Cancer Society and the National Cancer Institute.  If you want your money to go specifically to children’s cancers, you need to pick organizations that are solely dedicated to them (such as St. Jude’s Children’s Hospital, the Pediatric Brain Tumor Foundation, or the Children’s Brain Tumor Foundation).
  • There are a bunch of new brain tumor treatments on the horizon, but unfortunately, most of them target adults before they target children.
  • If you are diagnosed with cancer, you should collect as much tumor sample as possible and bank it (ask your medical professional or do a search for tumor banking).  This may be used to create a customized vaccine for your cancer.
  • Pork rinds are our best friends!

Pediatric cancer awareness should not be limited to a single month.  Every day, kids like Isabella are fighting for their lives while their families try to cope with their future’s uncertainty.  So the next time you find yourself with some problem, think about these kids and compare your problem with theirs.  That should help put everything in perspective.

        Thanks for reading the blog. 

      Wednesday, September 29, 2010

      CBS Story on Immunotherapy

      In case you missed it, CBS News had a story on immunotherapy, using vaccines to treat cancers.  It’s about a little girl who had a neuroblastoma, which is a cancer of the nervous system.

      http://www.cbsnews.com/stories/2010/09/29/eveningnews/main6912677.shtml

      Also, check out this story they did last May about tumor vaccines.

      http://www.cbsnews.com/video/watch/?id=5014935n

      Monday, September 27, 2010

      Tumor Vaccines

      The human body is an amazing machine.  Every day, billions and billions of cells carry out their function which allows us to think, eat, breath, and everything else that we do on a daily basis.  Cells go through a basic process of mitosis, or cell division, which is how certain parts of the body regenerate, such as hair, skin, and blood.  There are several built-in checkpoints during the cell cycle that regulate progress.  These checkpoints have various purposes such as ensuring that cell mutations are not replicated, cells are not replicating at too fast a pace, and that specific organs do not get too big.

      On a daily basis, cells are mutating, but our immune system detects and destroys these mutated cells.  When these mutated cells replicate too fast and the immune system does not detect these cells, the cells begin to grow uncontrollably and that is the basis of cancer.

      Our built-in defense system, the immune system, detects and destroys foreign bodies with amazing efficiency.  These foreign bodies can be viruses or mutated cells.  So along with the ability to “learn”, what else is amazing is that the immune system has “memory” so that if it detects a foreign body again, it can attack it even faster.  When you are given a vaccine (such as the flu vaccine), you are injected with dead versions of  the virus.  Your immune system then programs itself to remember this virus pattern so that if you are exposed to the virus again, it can attack and kill the virus before it spreads and makes you sick.

      A cancer vaccine works in a similar manner.  One difference between a cancer vaccine and traditional vaccine is that a cancer vaccine does not prevent the onset of cancer, but is only used to treat cancer.  But the basic premise is similar.  A portion of the tumor is resected from the patient along with their blood.  The white blood cells are then “taught” to detect the proteins of the tumor cells.  The white blood cells are then reinjected back into the patient where they teach other white blood cells about the cancer cells and go on to fight and kill the cancer cells.

      So, our best piece of advice that we can give you should you or someone you know be diagnosed with cancer is to always try and save a piece of the tumor.  Don’t assume that the hospital saves any of the tumor cells, and even if they do, the hospital legally owns it.  In addition, the tumor needs to be saved in a certain way in order for it to be preserved so it can be used for vaccine creation.  We wish that we had known about this when Isabella had her surgery, because for better or worse, she doesn’t have enough disease tissue right now to make the vaccine.

      Friday, September 24, 2010

      Flashes of Hope

      While we were at Camp Sunshine, an organization called Flashes of Hope donated their time to photograph every child at camp along with their families.  Today, we received the pictures and I am proud to share them with you.  Flashes of Hope is a nationwide organization that takes pictures of children with cancer and recently just photographed their 15,000th child.  A donation of $25 allows them to photograph a child and his or her family.
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      Flashes of Hope photographs its 15,000th child!
      Posted on September 10th, 2010
      This month Flashes of Hope reached a new milestone. Since its inception in 2001, Flashes of Hope has provided free portrait packages to over 15,000 families all across the country! This summer alone, over 3,000 children were photographed at camps across the country. In 2010, Flashes of Hope will photograph 50% of the children diagnosed with cancer in 60 locations across the United States.
      Flashes of Hope is a national nonprofit organization that creates portraits of children fighting cancer and other life threatening illnesses and raises money for pediatric cancer research. Families photographed receive a generous portrait package, all free of charge. The photographs, taken by award winning photographers, help children feel better about their changing appearance by celebrating it. For families of terminally ill children, it is especially important to have a portrait that preserves forever the bravery, grace, and dignity of their child.

      Monday, September 20, 2010

      A Desperate Diet

      Note that the following post does not constitute a recommended medical treatment for brain tumors.  We are posting this for informational purposes, and as always, anyone looking to follow this diet should perform all research and obtain advice from your medical professional.

      About a month ago, we started Isabella on a high fat, low carbohydrate diet known as a “Modified Atkins Diet” or MAD.  This diet stems from a diet known as a Ketogenic Diet which was first developed to treat epilepsy, but has been found to have positive effects on brain tumors anecdotally.  Typically, our bodies convert the carbohydrates that we eat into glucose, which is then sent to feed all parts of our bodies, including the brain.  When there is very little carbs in the diet, the liver coverts fat into fatty acids and ketone bodies.  The ketone bodies are then transported to the brain and replace glucose as an energy source.  It has been seen in laboratory experiments that cancer cells are not able to use these ketone bodies for energy and die or at least stop proliferating, while normal brain cells are able to use ketones and continue to function.

      In a normal diet, half of the caloric intake is made up of carbs, while 30 percent is fat and 20 percent protein.  So for a child that requires 1200 calories per day, this translates to roughly 150 grams of carbs per day.  On the MAD, we are limiting Isabella to only 20-25 grams of carbs per day!  To put this in perspective, here is a listing of some common foods and how many grams of carbs they have.

      FoodCarbs (grams)
      Ketchup (1 tbsp)4
      Popcorn (1 cup)6
      Watermelon (1 cup)11
      Potato Chips (1 small bag)14
      Apple19
      Bowl of cereal and milk28
      Chocolate Cake35
      Spaghetti (1 cup)43
      Rice (1 cup)44
      Kraft Mac and Cheese (1 cup)54

      As you can see, many foods are not even an option anymore, and with many more, we need to strictly control portions in order to not go over 20 grams.  For example, Isabella loves watermelon, so we give that to her as a treat, but we could never use up 11 grams of carbs at once, so we only give her a quarter cup of watermelon.  If you have time (and a watermelon), dice up a watermelon and measure a quarter cup and you’ll see just how small an amount that is.

      Because of that, we’ve scoured the Internet for recipes used by other parents and some are truly innovative in mimicking “normal” food with a low carb counterpart.  I’ve listed a few of these below. 
      • Roasted crumbled cauliflower to substitute for popcorn
      • Shirataki Tofu noodles as a substitute for spaghetti pasta (1 gram of carbs as opposed to 43 grams – and Isabella loves them!)
      • Microwave a slice of full fat American cheese and it magically turns into a tasty cheez-it cracker
      • Chicken breading made of crushed up pork rinds (Julianne’s dad actually ran out in the middle of the night to a gas station to pick up a couple bags of pork rinds!)
      • French toast made of crushed up pork rinds (these weren’t so popular, but as you can see, pork rinds are now a staple at our house)
      • Pizza crust made of riced cauliflower, egg and cheese
      • Bread made of flax seed and almond meal
      • Waffles made with ricotta cheese instead of flour
      • Mock tortilla crackers made of fried cheese (delicious with taco meat)
      Honestly, we don’t even know if the diet is working and whether we may be torturing her unnecessarily.  But Julianne and I agreed that if at any point Isabella insisted on eating the high carb stuff or lost too much weight, we would just let her eat what she wanted.  At this point, though, Isabella has been on the diet for about a month now and we believe that she’s adapted extremely well to it so far.  She has been able to maintain her weight and has been steadily increasing her total caloric input. Sometimes, she’ll ask for something that she can’t have, but we’ll offer her an alternative and she’ll eat that instead, and usually happily.  The hardest part is being out and having the “bad food” everywhere, such as all the free samples at Costco or the Ice Cream truck passing by the house (and not to mention Halloween coming up – yikes!).  If this diet ends up controlling the tumor growth and buying time, it’ll all end up being worth it.

      Isabella has her special low-carb cheesecake while everyone else had the regular cheesecake.  The crust is made of crushed macadamia nuts.P1030106
      That popsicle has zero carbs.  Nathaniel wants to make sure.
      P1030310

      Thursday, September 16, 2010

      Cooking Tumors with Lasers

      Last May, the FDA approved a device from Monteris Medical, Inc. that uses an MRI-guided laser to kill tumors that are otherwise inoperable.  There are only three such devices installed in US Hospitals, the latest of which went live at Barnes-Jewish Hospital in St. Louis just earlier this month.

      The press release is below.

      http://www.prnewswire.com/news-releases/treating-untreatable-brain-tumors-fda-approves-new-laser-surgery-61852567.html

      Treating Untreatable Brain Tumors: FDA Approves New Laser Surgery

      Monteris Medical Earns 510(k) Clearance for AutoLITT(TM)

      KALAMAZOO, Mich., and WINNIPEG, Manitoba, May 13 /PRNewswire/ -- An MRI-guided laser surgery method, in investigational use at both The Cleveland Clinic and University Hospitals Case Medical Center, holds promise for thousands of brain tumor patients and has earned clearance from the Food and Drug Administration (FDA) for use in neurosurgery. The first applications of the technology are expected to be for the treatment of otherwise inoperable brain tumors.

      The AutoLITT System uses an MRI-guided laser probe, passed through a small bur hole in the skull, to deliver laser interstitial thermal therapy ("LITT") to heat and coagulate the tumor from the inside. High-intensity laser energy is applied directly to the tumor, rather than passing through normal tissue, while the MRI measures the temperature inside the brain, showing thermal damage as it happens and facilitating precise control of the treatment. Once coagulated, the treated tumor mass is dead.

      "The AutoLITT procedure delivers new-found hope for patients who have previously been given limited options in the treatment of their tumors," explains James Duncan, president and CEO of Monteris Medical, the AutoLITT manufacturer. The system offers a potential option for patients with tumors that are too difficult or too risky to treat, tumors that don't respond to other treatments, and tumors in patients that are otherwise not good candidates for surgery or radiosurgery.

      About Monteris Medical

      Monteris Medical(TM) Inc. is a medical device company dedicated to developing new cancer treatment technologies that improve clinical outcomes, quality of life, and the cost and complexity of care. The company's U.S. corporate headquarters are in Kalamazoo, Michigan. R&D headquarters are in Winnipeg, Manitoba, Canada. The website is www.monteris.com.

      Wednesday, September 15, 2010

      Delivering Chemo Directly to Tumors

      Traditionally, chemotherapy is given orally in the form of pills or intravenously.  The medication would then travel through the blood stream to the affected cells and do their work.  One of the main problems with the traditional treatments is that the dosage has to be pretty high in order for it to have an effect on the tumors, which in turn results in a number of side effects (such as hair loss, vomiting, and compromised immune system).  Secondly, for brain tumors, the medication has to cross the blood-brain-barrier, further limiting its effectiveness.

      We’ve been investigating a relatively new process of administering chemotherapy for brain cancer patients.  A surgeon would insert a tiny catheter into the patient’s brain, then chemo would be given in tiny drops over the course of a few days directly on the cancerous tissue.  Since the dosage is a fraction of the traditional dose, the side effects would be fewer and milder.

      Obviously, the big risk is the initial surgery to insert the catheter, but this does sound like a promising new method to treat brain tumor while minimizing the side effects of traditional treatments.  There are currently clinical trials progressing in both adults and children.

      This article has more information:
      http://health.usnews.com/health-news/managing-your-healthcare/cancer/articles/2009/05/04/delivering-chemo-directly-into-brain-tumors-shows.html

      Tuesday, September 14, 2010

      FOX Sports and St. Jude

      This NFL season, FOX Sports wants football fans across America to get in the huddle with St. Jude Children's Research Hospital and help lead the drive against childhood cancer.

      This fall, FOX Sports has teamed with St. Jude Children's Research Hospital to help kids who are sidelined by cancer and other deadly diseases. This season-long partnership will include public service announcements that will be aired all season long—including Super Bowl Sunday—and feature additional on-air mentions and other St. Jude events and activities.

      Read more.

      Monday, September 13, 2010

      Father Fernando Suarez

      A couple of weeks ago, my aunt told me that Father Fernando Suarez would be coming to Connecticut to do a healing mass.  Father Suarez original comes from the Philippines and has claimed to be able to heal all types of ailments from a sore neck to blindness to cancer.  My aunt and my mom insisted that we take Isabella to the healing mass and although I was skeptical, agreed.
      While we were at Camp Sunshine a few weeks ago, we shared many stories with other families going through what we are going to now.  We heard stories of people taking their child to all sorts of “non-conventional” healers including some crazy stories with faith healers and with people flopping around the ground as they were “healed”.  Up until a few weeks ago, Julianne and I didn’t have to consider these other healings because the traditional treatment seemed to have worked and that stuff was for desperate families.  But we've tried a bunch of these alternative healings including energy healing, reiki healing, and now here we were walking into the church to attend something that we would have thought was crazy a couple months ago.
      The Mass itself was just like any other Mass and Father Suarez gave the homily.  Just from hearing him speak a few sentences, I could immediately sense his kindness and sincerity.  He was also very entertaining and shared many stories from his past.   My favorite one was when he returned to a Canadian church after three years.  He reunited with a couple that he met on his first visit.  The couple was having problems having children and they came to see Father Suarez to help them out.  Well it turns out that after seeing Father Suarez, they had three children in three years, and now they were coming to see him to make it stop! 
      The healing portion was scheduled for after the mass.  People who needed healing would walk to the front of the church where Father Suarez would pray over them and heal them.  The priest describing the process to us even joked that you don’t have to fall to the ground to be healed and you don’t have to go back to the end of the line to be healed again!  But just in case you do fall, they were prepared with catchers who stood behind you as you were healed.  (“Just be sure to pick a catcher bigger than you, or it could get messy”, he joked.  Julianne and I laughed thinking about those stories we heard about people convulsing on the ground.) The whole process would only take a few seconds per family/person, but we were dreading it because there were hundreds and hundreds of people attended.  We were sitting in the back of the church and there were hundreds more people waiting in the adjacent parish hall that couldn’t fit in the church. 
      Fortunately, they called up families with children who were 7 years old and younger, so we were one of the first ones to be seen when we took Isabella up.  Julianne, my mom, and I walked up with Isabella.  Next to us was another family who I overheard tell Father that their child also had a brain tumor.  When it was finally our turn, Father Suarez walked up to us and we told him that she has a brain tumor.  He told us to close our eyes as he prayed over us and at that moment, I felt a wave of air go over me.  I don’t know if he was blowing on me, or if it was the ceiling fans, or what it was, but I felt a giant sense of comfort and peace.  My mom and Julianne were crying as we finished up, thanked Father Suarez, and left the church.
      We don’t have another MRI scheduled until next weekend so we won’t know anything until then, but Julianne and I were glad to have gone.
      We would also like to give a special thanks to our family friend, Reggie, who provided us with special tickets to attend the mass inside the church.  Without those tickets, we would have been in the other building and waited much longer.
      If you have a few minutes, I urge you to visit Father Suarez’s website (http://www.fatherfernando.com/) and read his amazing story.  He and his group travel worldwide to do healing masses and actually went to Greece this weekend following the healing mass in Connecticut.  He also started a foundation where they feed thousands of malnourished children in the Philippines.
      Father Suarez readily admits that he does not heal people himself, but he is just an instrument for God who actually does the healing.  If we had more people like him to spread hope, faith, and love, we would live in a much better world.

      Saturday, September 11, 2010

      President Recognizes Cancers Awareness Month

      On August 31, President Obama proclaimed September as a National Cancer Awareness Month, but not for pediatric cancers – he proclaimed it for Prostate Cancer and for Ovarian Cancer.  I guess in the “better late than never” category, a full 10 days into the month on September 10, President Obama recognized September also as Childhood Cancer Awareness Month.  Here is the full release:

      Presidential Proclamation--Childhood Cancer Awareness Month

      - - - - - - -

      BY THE PRESIDENT OF THE UNITED STATES OF AMERICA

      A PROCLAMATION

      Each year, thousands of children face the battle against cancer with inspiring hope and incredible bravery.  When a child is diagnosed with cancer, an entire family and community are affected.  The devotion of parents, grandparents, loved ones, and friends creates a treasured network of support for these courageous children.  During National Childhood Cancer Awareness Month, we honor the young lives taken too soon and the survivors who face chronic health challenges, we celebrate the progress made in treatment and recovery, and we rededicate ourselves to fighting this disease so all children may have the chance to live a full and healthy life.

      While survival rates for many childhood cancers have risen sharply over the past few decades, cancer is still the leading cause of death by disease for young Americans between infancy and age 15.  Too many families have been touched by cancer and its consequences, and we must work together to control, and ultimately defeat, this destructive disease.  I invite all Americans to visit Cancer.gov for more information and resources about the symptoms, diagnosis, and treatment of childhood cancers.

      Tragically, the causes of cancer in children are largely unknown.  Until these illnesses can be cured, my Administration will continue to support investments in research and treatment.  The National Cancer Institute, the Federal Government's principal agency for cancer research, is supporting national and international studies examining the risk factors and possible causes of childhood cancers.

      The health reforms included in the landmark Affordable Care Act advance critical protections for individuals facing cancer.  Provisions in the law prohibit insurance companies from limiting or denying coverage to individuals participating in clinical trials, the cornerstone of cancer research.  After recovering from cancer, children can no longer be denied insurance coverage due to a pre-existing condition.  It also requires all new plans to provide preventive services without charging copayments, deductibles, or coinsurance, increasing access to regular checkups that can help detect and treat childhood cancers earlier.  The Affordable Care Act eliminates annual and lifetime caps on insurance coverage and prohibits companies from dropping coverage if someone gets sick, giving patients and families the peace of mind that their insurance will cover the procedures their doctors recommend.

      This month, we pay tribute to the health-care professionals, researchers, private philanthropies, social support organizations, and parent advocacy groups who work together to provide hope and help to families and find cures for childhood cancers.  Together, we will carry on their work toward a future in which cancer no longer threatens the lives of our Nation's children.

      NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim September 2010 as National Childhood Cancer Awareness Month.  I also encourage all Americans to join me in recognizing and reaffirming our commitment to fighting childhood cancer.

      IN WITNESS WHEREOF, I have hereunto set my hand this
      tenth day of September, in the year of our Lord two thousand ten, and of the Independence of the United States of America the two hundred and thirty-fifth.

                              BARACK OBAMA

      Friday, September 10, 2010

      Stand Up To Cancer

      tune_in_banner1

      The other day I mentioned that researchers need to start thinking “outside the box” when it comes to treating cancers.  Stand Up to Cancer is a relatively new charitable organization that funds these new types of treatment.  Not only that, but SU2C encourages collaboration among different researchers as opposed to the traditional competitive nature between them.

      This link shows all the new and innovative research that they are currently funding.  Some of them sound truly amazing!

      http://su2c.standup2cancer.org/su2c/about_us/innovative_grants

      SU2C will be holding a television special tonight, September 10th at 8:00 pm ET on all the major networks.

      It’s long overdue that we all stand up to cancer!