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VANYA JOFFE - 6 YEARS OLD

VANYA JOFFE - 6 YEARS OLD
" NUNU ''

Tuesday, March 30, 2010

The last 72 hours at home and in hospital

Friday evening was relatively ok and so was Saturday , the only side effects being the fatigue , headaches , some dizziness and sometimes tummy pains .

However , at 3am Saturday morning we woke up { still don't know how , perhaps instinct} to find a very hot Vanya lying next to us - her little body felt as if it were on fire  . She had been sleeping with her sister Jaydene but had a bad dream about lots of injections being stuck in all over her body .

We realised again that we need to arrange a session with the resident clinical psychologist at Panorama hospital , and also immediately discovered an alarming temperature of 38 .7 - remember we had been warned at that point to get to hospital immediately {from 38 in fact} .

 Mom called the hospital who advised to wait another hour and then act accordingly . We gave Brufin as she is not too partial to Panado syrup and says its getting boring and yuggh.. Dad did the first 2 hour shift staying up to monitor her temp every half hour and with a luke warm face cloth and opened sheets we got it down to 37.3 . Dad decided to sleep a bit asking Mom to try keep watch - I think we all slept for a while .

Dr. Stefan called on Sunday morning having checked that we called in to the hospital  and wanted to know how Vanya was doing . We updated her and found out that we should not have given Brufin as it can lower the blood platelets - oops , sherbert ! We were told that if she reaches a temp of 38 again we should come straight in and do not even give panado syrup yet , as it was infection setting in and she would need an antibiotic drip , blood tests and maybe a transfusion . Thank God for the catheter with all this activity going on - it's pain free and no needles .

Fortunately the rest of day went ok besides the head and tummy aches { chemo working } . Her appetite for now is great { thanks to day 15 of 36 steriod tabs} - she eats like a baby horse and her cheeks are getting chubby with her tummy always solid like a barrel . We have to monitor her bowel movements too , and have discovered that she has been holding in her urine and that could cause infection so we have to monitor that too.

On Monday we met Dr. Keeting and Dr. Louw who discussed the bone marrow extraction procedure with us but were concerned about the low blood counts in certain areas . After consulting with Dr. Stefan they decided to go ahead and while under also do the sore chemo injection , it's called a laspar injection{ no. 2 and Vanya is counting and asking if she can't sleep for all those ones , but no ..} - we will try increase the pre-med a bit for the others .

It took about an hour for her to regain full consciousness again and was immediately hungry asking for a pie and ice tea and had lots of water . Then came the wait for the blood to arrive as a transfusion was on the cards . It arrived at 7pm and took about 3 hours to complete , this time without reaction { I wonder if the last lot was in fact filtered and radiated blood as it should have been } , as opposed to regular blood they use in emergencies .

Mom did the night duty last night and its Dads turn as soon as todays blog is done , I am on my way together with the munchies from home that Vanya ordered . I guess I'll get updated from wifey on arrival .

Hope to come home tomorrow , but on this journey as we all know by now the route changes by the day and we just adjust our sails accordingly and ensure that it's only forwards we go . . day by day , treatment by treatment , the next one being scheduled for Thursday and it's the sore bum one .

Our whole family once again express our innermost gratitude for the warm support ans wishes along the way

Friday, March 26, 2010

Freak- out Friday teaches us our first practical lesson

Off we went to hospital as positively as usual and wondering what these early morning or late night trips would be like as winter sets in . Never a dull moment in the car as my dear wife bubbles away non - stop but thats her way of dealing with nerves { by her own admission} . Me , I tend to go quiete until of course I have to deal with things at the hospital , and man did we have to this morning !

Much to our surprise the fantastic Sharon was on duty in another ward this morning and another very young and seemingly inexperienced nurse was allocated to our treatment , this was problem number 1 - when she tried to flush clean the catheter before the routine blood test we discovered it was blocked . After 3 attempts still blocked ! They use a strong chemical called Heparin diluted with Saline solution to clean the pipes prior to action , but today no way - now what ?

Our nurse disappears to try call Sharon to ask for advice but returns to say that our good Dr. advised her to draw blood peripherally from the arm as they have to check the blood counts to assess whether the chemo plan can go ahead or not .

This was problem number 2  - after convincing Vanya that it's only another quick bee- sting and all over our nurse decides to say 2 wrong things : "don't worry honey I am also scared of needles" and " we'll just stick it in and hope for the best" . The result was no blood and problem number 3 - she missed the vein !! Well that's when Dad sprung into action as calmy but assertively as possible {although Sylvia did not think so } .

Within 20 minutes I  had Sharon back there and guess what ? in 10 minutes she had the pipes cleared , the blood drawn and off to the lab for testing , no pain , no fuss ! Then came the wait to see if the white blood cells or platelets were too low or high meaning no chemo today and maybe a blood or platelet transfusion{an all-nighter } .

If high enough then we would have the 1st of 8 bum injections . It came back with a count of 63.5{platelets} so the injection was on , below 50 it would have been off .  First the Emla patch to numb the skin as this was the sore injection remember !

This was the longest "eina'' scream we've heard so far , as this one burns right into the muscle and we had to restrain her hands and legs { well mom did } until I was called to help .

That's how our day ended and after a 2 hour obseravtion period to ensure there was no allergic or epileptic reactions we were on our way home with OUR CHAMPION CHILD WHO HAD BRAVELY OVERCOME ANOTHER little BATTLE - AND MANAGES TO MAINTAIN HER GOOD SPIRITS { oh and we had to stop on the way home to buy 2 budgies }.

May this weekend be filled with peace , health and love as we wait for Monday 10h30 - bone marrow extraction and 2nd bum injected chemo . 6 more to go every 3 days which will not be easy for us as Vanya has had a taste of how sore these ones are .

Thursday, March 25, 2010

Tomorrow brings something new on day 15 of 64

We received a call today to be at hospital at 8am tomorrow for Vanyas first chemo injection in the glutous maximus { we call it bum-bums} . They say this is the really sore one but they use the amla patch to deaden the area a bit .Still we are all anxious to see that it'll be fine as there are many more of these to come and have heard that some children get allergic or epileptic type reactions - be strong my little one . .

Yesterday and today seemed ok for all and the only real signs were fatigue , hunger and a little light headedness , otherwise Vanya is holding up well , stilll brave and strong .

We received some more homework today and good food , flowers and more from 2 or more  moms - thanks so much , you know who you are -it's a great help always !

And so our journey continues on day 15 of 64 in the first treatment phase - 23 % of the way there but only the first round and we know the treatment is starting to work for our precious daughter .

Here's looking forward top a peaceful weekend for all and more healing time with its ups and downs . I must thank my beloved wife Sylvia who is just amazing with Vanya under trying times . There are some things that only a Mom can do no matter how hard Dad tries it's just not the same . . . .so it's go to be back to back , united we stand , divided we fall {and thats not an option }.

We became aware again today to ensure that we  give attention to our other children as we can see they starting to feel left out with all the attention Vanya gets . We will work on this as best we can .

Best get a reasonably early night as we leave quite early tomorrow and it could be another long day  , maybe 1 movie to take our minds away a bit and then zzzzzzzzzzzzzz.. Good night all and once again thanks for just being there !

Tuesday, March 23, 2010

Our first intravenous chemotherapy treatment

This morning was filled with silent anxiety as we waited for the blood test results they do before each chemo session . After 2 hours it arrived and although the haemoglobin was a bit low as well as the platelets , it was not threatening and Dr. Stefan decided to go ahead withthe first round of chemo through the chest catheter .

First there was a 200ml bag / 27mg of a drug called Daunorubicin which looks a bit like orange lucozade and took about 1 hour to complete . Prior to this they administered Zofran 2mg for nausea and the second drug was a 50ml / 1.35mg bag of Vincristine which took another 1/2 hour .

Besides receiving 2 lovely Hannah Montana hampers from Pick 'n Pay head office that was about it for the day which began at 9am and ended at around 5pm . Oh , and we also managed to catch up with lots of homework on the bed and plenty snacking .

Vanya was in good spirits and actually cracking jokes and demanding lots of stuff to eat all the way home .
We 'll have to see what the night has instore for us but so far so good , although they say the chemo works through the body for a few days until the next treatment so we could still expect side effects along the way .

Our next visit to hospital providing all goes well is on Monday 29th{and maybe Friday before that as well- to be confirmed} and it's for another bone marrow extraction for testing { lumbar punch} - quite sore and causes some anxiety with all of us ,  but the paediatrican is great and said that he will increase the dose of pre-med next time .

This will take us to day 15 of the first 64 day session . . .

I have to go to JHB tomorrow and hope Sylvia and Vanya will be okay , only back at 10pm

Monday, March 22, 2010

Today we wish to express our innermost gratitude

To the wonderful parents and teachers of our daughters school - Chesterhouse .We are so grateful for all the calls , sms'es and emails we receive . Thank you all for the visits , gifts and food at Tygerburg hospital !

Ann Cordner and Marjo Prins - we were blown over with your visit and your sharing and caring . As for the build- a bear with the recorded messages from the children and embroidered names - wow!  it was so touching!

Thanks to all the parents for your joint effort in comforting us and Vanya with your visits at home and in hospital - it's sometimes all surreal to us and we still can't or don't want to believe this is really happening .

Today Vanya decided we should have another picnic as some of our family came to visit . The steriod pills continue to build up a huge appetite and keeps us busy in the kitchen . Thankfully for now , Vanya has no aches and pains besides a tummy ache last night . Although she does seem to be tired quite often during the day .

Tomorrow it's off to hospital for chemo if the blood count allows . If not it could mean a blood or platelet transfusion . At least for now we know there is no infection and we are doing our best to keep it that way . \

Love to all and thanks once again !

Sunday, March 21, 2010

Sunday with the family - all the brothers and sisters

Last night was a good one for us all and we managed to get a good sleep . The first thing Vanya asked for when she woke up was Kelloggs Cornflakes , peanut butter sandwiches and doritos cheesy flavor chips - perhaps the steroid pills they warned us about is starting to stimulate her appetite .

We have to remember the pills are 3 x per day { 4 at a time} for 36 days , it's so easy to forget but from now on I will cell- a - rise it , so I can remind Sylvia when we're not together .

Vanya seems in good spirits for now and anyone visiting today would have no idea that she has leukemia and what she is about to go through - as it is still early days .

Vanyas cousins Tiffany and Kim came to visit today and she enjoys their company so much . She shows everyone her new catheter in her chest , blissfully unaware of what lies ahead eventhough we prepare her nicely day by day .

For the rest of the day , we're all going to chill with movies , books and maybe later some school homework with Vanya .

Saturday, March 20, 2010

And so our journey continues . . . .

The catheter op was successful yesterday and x- rays all clear . When awake Vanya had lots of pain that Panado syrup could not handle , nor her kicking tantrums . What did work was some Vala..drops { can't remember the exact name but will soon }- sorted her out in 5 minutes flat for the rest of the stay .

It's Saturday lunchtime and we just arrived home with Vanya after spending the night in hospital .
We should have come home yesterday already but had a slight complication - the blood test showed low HB{Haemoglobin} which is never a good sign we learn and more often than not requires a blood transfusion .

We waited form 2pm to 7pm for the blood to arrive {which we discover is the norm so get used it we must} - from there it was to be a 4 hour transfusion ,a 1L bag of human blood delivered in a cooler box with ice brick from the blood bank  . All went well for the first hour and then Vanya got the cold shivers , teeth chattering etc. We discover it's called Rigor ,  when she is actually hot in temperature and body but reacting this way at the same time . It's the first time she has ever had a blood test or foreign substance in her body { this type anyway} .

Dr. Stefan orders the transfusion to stop immediately and to connect a saline drip and administer Panado syrup to contain the temperature which was hovering at 38 ! and requests that we are to stay hospitalised for the night for monitoring .

An extra bed was arranged for me next to Vanya and we soon got a good , relatively undisturbed nights rest . They only monitored Vanyas temperature through the night and vital stats -all was fine .

Early this morning we had to draw 4 tubes of blood for testing both her counts and the blood that was used for transfusion . I learn from the sister that their is normal packed blood bags and filtered blood , she does not say much more , but I make a note to discuss with the Dr.

We remain in good spirits and Vanya hears we can go home and slowly becomes more mobile and ready to go when Mommy comes to fetch us . We have already planned a picnic at home inside as all the brothers and sisters are together this weekend , and it's amazing how compassionate and empathetic they are . . great kids really bonding more than ever before - we are blessed and truly grateful for the love , prayer and support we are receiving daily from all or friends , family , colleagues .

Our first chemo session through the new chest catheter has been moved to Tuesday due to the public holiday Monday , so we look forward to a nice family weekend together , good food , movies and lots of love and quality time . There is such a calmness in our home right now and I am being called to the picnic right now  ! got to go ...

Decided I would round off and then join them for the movie , also saw all my typos and discovered an edit posts section to fix it quickly. I still have to add phtos and finalise page layouts and all but will do as time goes on.

We were given a " what to watch for with chemo'' sheet to share with all family members and it covers Mouth sores , appetite , nausea & vomitting , bowel habits and tiredness - with tips and advice on what we can do .

We also still need to watch other signs very carefully and get to hospital when necessary . These include fever , red blotchy bruises under the skin { needs platelet transfusion} , deep anemic eye area { dehydration} too mention a few .

For now , all things are so normal it's hard to believe what we are all still to face these tough times ahead .
We must gather our courage and stamina in these good times too see us through the harder one's for we know that Vanya has started healing already , slowly but surely .

. You see , we believe that if you will it , it is no legend and we shall not question Gods bigger plan for our family and loved ones .

To the few of you following our blog so far , thanks so much for it's nice to share and we welcome any advice as to what or how we should be sharing our events as they unfold . If it's too emotional and sad , or to formal , whatever let us know so we can share it in even a better way , and Bless you and your families !

Thursday, March 18, 2010

Still Thursday 18 March but feels like another day . We received a call from our Dr. Stefan to take Vanya in for blood tests and to get some more pills to deal with her tummy and headaches .

She thinks its the chemo from the lumbar punch they did last Monday but wants to ensure that the blood count is ok prior to the Broviac pipe {or Hickman catheter} is inserted into her chest tomorrow .

Vanya does not want to eat or drink anything yet today so the pills which are meant to stimulate her appetite has not kicked in yet .

We need her to eat well today as she may not have any food or liquid from midnight tonight as prep for the operation tomorrow .

Still busy finalising the medical aid pre-authorisations due to confusion with the transfer between hospitals and the short notice for the operation at 8AM tomorrow .

So , for now it's off to Sharon the wonderful nurse at the hospital for bloods and medication .

How it all started - allow us to share our journey with you . . .

THE STORY OF OUR LIVES - OUR PERSONAL DAILY DIARY

We'll start slowly as we want to share our experiences with anyone in the world whom it may help . Those in the same boat behind us , ahead of  us and beside us . Join us and lets share with our families and friends who we know really care and will always be there . We know we will need them along the way .

Let us share with each other - strangers in cyberspace but universally connected by a common life - changing and humbling event in our own journeys on earth .

We have quickly learned to take it day by day , treatment by treatment , week by week , month by month and so we'll go on this roller coaster of a journey they say - we can only imagine but don't really know .

THURSDAY 11 MARCH 2010

We received the most awful , heartbreaking news a parent could take - our precious Vanya at 6 years of  age was diagnosed with Leukemia which we knew was cancer of the blood and thats all we knew .

We sat in disbelief with our Paediatrician , listening to the process and options ahead as we wondered if it could be a mistake or a mis-diagnosis but no it was true and shocking to the very core of our souls .

Within an hour we had booked into the paediatric oncology ward of Tygerburg hospital having been told it was one of the best with a great team of Doctors . We had a brief induction with Dr. Uys and were put in a room on our own but noticed the other wards had several patients in.We would move there soon they said .

As the door closed we felt as if we were imprisoned , alone and depressed while trying to answer our childs questions as honestly as possible but not knowing what was to happen next . Daddy took the first nightshift and sleptover whilst Mommy went home to our other children , a brother of 12 and sister of 16 .

I believe they all cried through the night as they tried to sleep and the next morning my wife Sylvia pulled herself together as a mother in - deed can , and gathered whatever we needed to make the stay at hospital as comfortable as ever .

FRIDAY 12 MARCH

We spent the day there together and were briefed again about the different types of Leukemia but would have to do a bone marrow extract within 24 hours under conscious sedation for testing so they could adopt the appropriate protocol of treatment .

We had to make our own food as this was a State hospital and rather run down but we knew we had to saty there for now until we understood more , so we settled into routine as best as possible and Mom took this night shift .

That night I felt how it was cold and alone in an empty bed with my one son not being able to sleep but for some reason I had not yet shed my tears although emotional at times , I was holding back still trying to come up with a plan to resolve this situation .

Our journey will continue soon - need some sleep , its 3AM  ....