Hannah's Test Site

Sorry for the delay in the post, but I think someone has put our clock on warp speed and time is just flying by. Clinic was difficult for Hannah again, just a lot of drama. Hannah received an extra drug along with the chemo as a preventive medicine for pneumonia. She has had this drug 2 other times, without too much difficulty, but it was really bothering her stomach yesterday. The drug lowers your blood sugar so that you feel nauseous. She surprised me though by eating some ice cream on the way home from clinic.

Even more surprising was that her counts have remained fairly good and stable so far throughout this cycle. If she was feeling better, she would be able to go to school right now. But, with so many kids out sick and with Hannah not feeling very well herself, she just can't go right now. I am anticipating she won't be back until at least after the first of the year. She is so fatigued. She got up this morning at 10:15! It was good to see her sleep in, but she had a stomach ache when she woke up. We stayed at home today, did some homework, and only left to pick up Colby.

Tonight we got out the Christmas decorations to decorate the tree and the inside of the house. Hannah was very excited, but just so tired. She alternated between putting the ornaments on, resting, and crying. I must say the tree looks great, although the rest of the decorations are still in the boxes in the middle of the living room. I'm contemplating leaving them there until after Christmas! Think anyone would notice?

Hannah and I made our first Christmas cookies today. We had made the dough last week, and never baked them. We put so much work into making these cute little Santa cookies, but they were a disaster. Their heads, arms and legs fell off after baking, so they were more like Santa parts! They sure tasted good, but what a waste! We had picked out about 12 different cookies to bake this year, but after today, I have decided that we will be making "spring cookies" this year for everyone. This will be the first year that I don't make thousands of cookies for family and friends, but I just can't do it. Christmas is 2 weeks away and I am so far behind! When it comes down to it, what really matters is that we are all able to celebrate together, Hannah is done with chemo, and I hope this is a new start for her. Grandma and Grandpa are coming out for Christmas and bringing Sydney (my sister's daughter who lives in Illinois), so they are VERY excited about that. We have a lot to be thankful for this year.

I will leave you with a few pictures of us picking out our Christmas tree, and the decorating tonight.

xoxo Kim

One more chemo down and only 2 to go. Hannah did well yesterday, most likely due to the extra anti-nausea meds I asked them to give her. She played video games in her bed almost the entire time, and fell asleep with only 15 minutes left to go! I won't go into details, but she was very agitated when they went to access her port, they called for another nurse (that's a first), and Hannah was NOT happy.

She was a star at clinic yesterday. One of the nurses who was at the fantasy flight pulled up the video on Newsday.com and we all watched, which was pretty exciting for Hannah, since she had not seen herself online in the video yet.

Her white counts were surprising good yesterday, up quite a bit from last week. The doctor mentioned that this is normal as the body is making one last push for recovery, which will probably be followed by a dramatic and quick drop in counts. I guess we have that to look forward to for next week. I had hopes that she could make it school this week at least part time with these counts, but realistically, she does not feel that great. Last night she was complaining of a stomach ache, and she will still be on 2 anti-nausea meds for the next few days, one of them which makes her very tired. I am not pushing her to attend since she doesn't feel good, and she is still sleeping this morning.

I'm sure she'll talk me into baking some cookies today, that's been on the top of her list for quite a while, and the dough is already waiting in the refrigerator. I'll leave you with a picture of Colby and the brothers in the house, when they are not playing together they are cuddling!

xoxo Kim

The big highlight of the weekend was our trip to the North Pole. Anyone who lives in the area may have seen the story on Channel 7 news last night about the "fantasy flight." This is something Schneider Children's Hospital does each year for their oncology/hemotology patients.

We arrived at LaGuardia airport at 10am. The flight was to take off at 11am, and arrive shortly after at the North Pole. The NYPD band was playing, the area was decorated and busy with Santa's elves, Rudolph, Shrek (what's Christmas without Shrek?), and tons of reporters and camera crews. We saw several kids we knew from clinic, and some of the staff with their kids also, which was nice. The pilot-Captain Carl, was mingling about and stopped to talk with us for quite a while. He explained to Hannah that he had surgery, showing her the scar on his head too. At one point, he came back to ask Hannah to dance on the congo line with him and to my great surprise, she did! Here they are dancing away!

Then the time came to head to the gate and board the plane. We had to do the normal security check, shoes off and everything. It was very official and the anticipation began to build. We headed over to the gate and boarded the plane. After everyone was on, we were instructed to put down the shades on the windows, after all it was a secret flight to the North Pole. The pilot started the plane, we backed away and "took off". The plane taxied over to the North Pole, probably about 15 minutes total while we all sung Christmas carols together. We sat next to another little girl and her family, turns out she had medulloblastoma too. She had a stem cell transplant in July, since her cancer also extended to her back. She was still wearing a mask, since she was still at risk for germs.

We all got off the plane in the North Pole and were greeted by Santa and Mrs. Claus. The area was sectioned off for us, and decorated with tons of balloons. There were carnival games, face painting (where Hannah tried to talk the lady into a full head painting), an area to talk to Santa, a large food buffet, a jumpy blow up, and Hannah's favorite-cotton candy. Here is a picture of Hannah and I with Santa. Everyone was just so caring and giving and supportive for all the children. It was really amazing, and much more than we had expected.

I just checked Newsday's website, and they have a video taken during the party. Our friends Debbie and Jake are on there, as well as so many others we know, and Hannah and I too! Check it out HERE. After the Newsday site comes up, look for the video section down a bit on the left hand side. The video is entitled Kids Fly to North Pole. For now, it's the first video listed. It gives you a good feel for what it was like, exciting and fun!

I'll leave you with a few more pictures of the day. Tomorrow is another chemo day, one more closer to the end.




xoxo Kim

This has been sort of a crazy week here at our place. Monday was chemo and the blood draw to check Hannah's adrenal function, Tuesday Hannah felt surprisingly bad, Wednesday Hannah lasted 1 1/2 hours at school before coming home too tired and then at night the news of her test results.

Although our oncologist had told us that "this isn't normally an issue, and I'm not concerned about Hannah", her cortisol level came back at .3. Without even knowing what the normal level should be, I knew this didn't sound good. Normal cortisol levels when drawn between 7 and 8 am should be 5-23. The lowest acceptable level is usually around midnight and is 3-15. This means that her body is producing almost NO cortisol.

For those of you that want to know what this means, read on. If you want to skip all the technical jargon, head to the bottoms. Basically your body's stress system relies on two main hormones-adrenaline and cortisol. Everyone is familiar with adrenaline, and how it works in your body short term if your body senses a stress situation. Cortisol is similar to adrenaline and works in the long term. These hormones control many important body functions like regulation of glucose, blood pressure, ability to fight off infection and reduce inflammation (also key in fighting tumors) and many other things also. In times of stress of the body, the cortisol level increases dramaticallly to ensure all of these important body functions continue normally. That is a very simplified explanation of a very complicated hormonal process.

The risk to Hannah with such a low cortisol level is in a stress situation to her body. Stress situations include fever, cold, virus, vomiting, anesthesia, broken bones, etc. Her body could not produce the necessary cortisol and she would most likely become hypotensive and go into shock. Doctors do not immediately look for adrenal suppression and assume that there may be an infection, so the wrong thing is treated which can result in serious complications or death. However, because we know Hannah's cortisol is low, we will always be able to mention this to the doctors if Hannah is sick or in a stress situation. The had us fill a prescription at the pharmacy already so that we always have hydrocortisone on hand, should Hannah become sick and need it right away.

My first question was how this was to be treated and how can we fix it right away. I feel like she is a walking time bomb. I assumed they would give her hyrdrocortisone to increase her cortisol level. However, the doctors want to do nothing! We are slowly weaning her body off the Megace appetite stimulant and hope that her adrenals will begin functioning normally after it is out of her system. They do not treat low cortisol in this case, because giving another steroid is doing nothing but replacing one steroid for another. It will not help the adrenals to recover their own function and will basically continue to keep them suppressed because the adrenals will not have the trigger to know the level is low. It can take some time for her body to recover on its own after the steroid is stopped, we don't know exactly how long. They are going to draw blood again 2 weeks after the Megace is completely stopped, but I have seen data that says it is sometimes 1-3 months before the levels are normal again. There is also a possibility that her levels may never come back up due to permanent adrenal failure, in which case they will decide to either supplement with a steroid for the rest of her life, or always keep the hydrocortisone on hand as a stress dose.

So for now, we are watching Hannah for any symptoms, or I should say increased symptoms. Symptoms of low cortisol can include fatigue, increased susceptibility to infection, muscle aches and pains, feeling cold, impaired memory, decreased recovery from exercise, allergies, low blood sugar, burned out feeling, depression, and reduced sodium and potassium levels to name a few. Out of this list, Hannah already has nearly 2/3 of them already. We are also keeping Hannah out of school for now. She is still on chemo which means her counts are dropping, leaving her even more susceptible to infection, especially at school. She really doesn't have the stamina now anyway to attend regularly. This means she will probably be out the whole month of December, continuing on into January. This is quite disappointing, and although I know Hannah enjoys time at home, I think this will bother her to be out for such a long time without that peer interaction. But, we have to weigh the odds and the consequences are too great. Before I say for sure though, we're going to see what her counts are on Monday when she is scheduled to get chemo again.

Sorry for the very long post, hope your eyes are still open! Thanks for visiting, and we will keep you updated as always.

xoxo Kim

One day after chemo, Hannah spent the day at home today. After not feeling well last night, I tried to wake her this morning and she was really having a hard time. I finally decided to let her sleep and go to school a bit late, because she usually wakes by 8 or 8:30am or so. She slept until 10:30, then looked pretty rough. She had dark circles under her eyes, wasn't eating anything and just seemed very lethargic. By mid afternoon she was complaining that her stomach felt "funny", more nauseous than painful. I gave her some more anti-nausea meds at 4pm, then again before bedtime. Hopefully that will help for tomorrow.

I am surprised that this chemo has hit her so hard so early. The first two rounds of this medicine was easier than the others. The first time Hannah had this medicine, she had absolutely no reaction, and her blood counts stayed up. The second time (which was round 6) she also handled it well, by the 4th dose at the end of the round, her counts were quite low and she needed a platelet transfusion. But, through all of that, she didn't experience much other than tiredness. Llike they told us, each round is harder on the body, and this being the last, I guess even the easiest chemo affects her quite a bit. I'm a bit nervous because this is the first of four days of chemo, I'm sure it will get progressively harder.

I hope she is feeling better by Saturday, because we have been invited to go to LaGuardia airport on Saturday for a trip to the North Pole! We board the plane, and head over to the North Pole (which means we taxi over to another gate), and when we arrive, we are in the North Pole complete with Santa and elves. Hannah is very excited, and I am as well, it sounds like great fun and we are so happy that Childlife has invited us, since it's by invitation only. I'm sure we'll have lots of pictures from that.

Until then, we will just keep an eye toward the prize....the end of chemo.

xoxo Kim

Another day of chemo down, three more to go. We arrived early today to have Hannah's blood drawn for the adrenal test, however they didn't get around to drawing it until 10:30am. Unfortunately, the cortisole levels peak around late morning and we want a reading at their lowest to be able to get an accurate reading of how much cortisole her body is producing. The test results will most likely be ambiguous, but we'll see. If they show low anyway, then we know there is a real problem, when they are supposed to be at their highest. Most likely, we will need to have it done again. Next time I'll do it myself if they can't get it together. The results should be back by Wednesday or Thursday.

Hannah had a good day today, slept during most of it and we got home about 5pm. I must say she still HATES to be accessed, today was very bad for her. It could be that she was sleeping when they finally got around to doing it, and I had to wake her up and carry her over to be tortured.

She is now happily telling everyone that we only have "three more Mondays and then we're done with chemo!" She even told the security guard today when we were waiting for our car. She has some BIG plans for after chemo, that's for sure. She is still trying to figure out a way to get to Grandma's house for Christmas. I broke the news this weekend that it really wasn't possible, even though we're done with chemo, her counts will be very low for the holidays. We don't care though (I can say that now, just as long as we're not in the hospital) as long as we didn't have any more delays. Hannah also has some very ambitious plans for making something for everyone at clinic for the holidays. I was thinking cookies, but she is thinking cookies AND ______ AND _______, can't give away the secret yet.

She was very talkative tonight on the way home, ate lunch on the way home and also a good dinner. After dinner she complained of a headache. I was then getting her ready for bed, figuring she wouldn't do any reading for school, but she wanted to read a book, so we did. She read for 55 minutes! On and on, she wanted to finish the book! Unbelievable for a kid who just had chemo pumped into her little body today. She went to bed fine, but was crying a short time later because her head hurt pretty badly and she felt sick. I gave her some more anti-nausea meds, hoping it works on her head also. We'll see how she feels for school tomorrow.

A bit blurry, but you get the idea!

xoxo Kim

You may have noticed that I added another element on the left hand side. This is a video from Hannah, made by Hannah and edited by Hannah. She also chose the music by herself from some I had on my computer. The song is from Mark Schultz entitled Broken and Beautiful, how appropriate is that? I didn't even know she was doing this, or see it until after she was done. She was very proud of this video, and wanted to show everyone what her life was like during her treatments. She also included many pre-diagnosis pictures of herself, which may be interesting to those of you that didn't know Hannah pre-diagnosis.

I think it's awesome, and it brings a tear to our eyes every time we watch it. Dave and I just looked at each other after we saw it for the first time, not knowing what to say.

Some of the photos are a bit blurry, and I'm trying to fix that, but until then, I hope you can view it and enjoy.

xoxo Kim

Being thankful is the theme of the weekend. This Thanksgiving has been a bit different, finding out that a good friend just had a poor MRI showing new growth of his tumor, dealing with another possible health scare with Hannah, and receiving notification that our health insurance has been cancelled. WHAT??

Ok, we became aware recently that the appetite stimulant Hannah has been on for several months is 1) a steroid and 2) the cause of adrenal suppression in many pediatric patients. What does that mean? It means that it could cause Hannah's level of cortisol to be severely decreased or eliminated all together. This is a very serious issue, and if not diagnosed, results in death due to cardiac arrest. This was brought to my attention from a post online by a friend whose son just experienced this exact situation. It was a very scary situation and required immediate interaction with supplements, which he may need to now be on for the rest of his life.

We immediately started researching and emailed Hannah's doctor (who is the same doctor as our friend that just found the problem). He did say he is not concerned about Hannah and this condition, but agreed to have her levels checked. They have to draw blood in the morning, so Monday morning before chemo, Hannah will get a blood draw to check to see if her levels are adequate. I would also like to take her off the steroid as soon as possible, but it has to be tapered down, not to cause the same issues with her levels. We'll be looking for something else to help her eat, which is still a daily struggle.

And our health insurance-it seems our insurance company has decided to pull out of New York, which means they have dropped us. They gave us the required 6 month prior notice. We are now working with our insurance rep (and good friend) to see what our options are.

But with all that craziness happening in our lives, we still have much to be thankful for. Here is Hannah's Thankful list, which was published in our local paper this week along with others from some of her classmates. Hope everyone can read it, they published her original letter.

xoxo Kim

HAPPY THANKSGIVING!!
We started off the day with a 5K Turkey Trot, an annual fundraiser for the high school. We did this race last year, before Hannah was diagnosed and Hannah came in 2nd in her age group. Last year the weather was horrible, with driving rain and cold, but today it was beautiful and even hot once you got going. I was thinking today as we did the race that last year, even with that stupid tumor in her head, she was able to run/walk the entire way!
This year she did great, walking the start, walking some during the race and even running across the finish line. The rest, she was in the stroller, enjoying the ride. I was happy we were there and she could participate at all, amazing! Here is a picture of us before the race, and of Hannah and I at the finish line.

We headed out then for dinner with Aunt Kathleen and Bill. Here is what Thanksgiving looked like for us-of course Tod was there! All was great and it was a relaxing and wonderful afternoon.
I read something recently on another child's website named Coleman, who also has medulloblastoma. He is adorable and only 4 years old and just recently had a relaspse of the cancer. I visit his site often. Yesterday is mom posted that she "read something about how when you take a road trip to a beautiful place, you may have to drive through storms, forks in the road, twists and turns…the scenery along the way may not be as pretty as your final destination, but you must take that road to get you where you want to go." That’s how we’re thinking of our journey, we’re a few more miles down that road. Hannah in the home stretch.

So much to be thankful for including all of you. Our love always,

xoxo Kim

We went in today for a clinic appointment as well as an audiogram. Hannah's counts were acceptable, her white blood count and neutrophil count went way down, which I had expected since we stopped the shots to keep them lifted. They both went down by more than 50%, while her red blood cell counts continued to go up. All counts are good enough to get chemo next week, even if they are still not in the normal range. Once they start on Monday, we will continue through, no matter how low her counts go (to a point I guess.) It's almost surreal to think that we will be starting her FINAL round of chemo next week. I hope we never have to do chemo again, that is my holiday wish.

Clinic was kind of fun for Hannah today. We brought in a huge box of crafty items from Oriental Trading. This was from Hannah's Cans for Cancer funds. She had the best time shopping for all of the goodies online. We knew they needed craft items, so we brought in several of Hannah's favorites. So many of you have had a hand in this, THANK YOU SO MUCH!

Next was Tod! We had him hidden in my bag under the blanket when we first arrived, trying to keep it low key. It was obvious that that was not to be for very long. Jan, Faye and Rob got him first, then all the nurses came in to see him, then lots of our friends at clinic including Kaitlyn and her mom Carolyn. He wasn't hidden after about 2 minutes. Hannah loved showing him around, although at one point it became a bit overwhelming for her. Not only is she still tired physically, but she is also tired emotionally and things that would not normally bother an eight year old bother her. I believe this is still a side effect from the surgery (posterior fossa syndrome), but it could be a combination of the surgery, the radiation and the chemo. I don't know if it will go away or change at all. We are used to it, but I know it surprises others (why is she crying?). She usually gets over it quickly if she is distracted.

Then we headed to get her audiogram. Her hearing is at jeopardy from some of the chemo drugs, so she has to continue to get her hearing tested. Her hearing declined again today, although only significantly at the highest frequency. Her hearing in the normal frequency is still within normal hearing range. It can still go down, but has less of a chance to do so without the damaging chemo drugs. Again, Tod was a big hit, except with one lady who said "you know that is not allowed here, but I won't make a big deal about it." We were on our way out anyway.

I forgot to take my camera today to clinic so I have no pictures to post, unfortunately. We'll try to get some more Tod pictures on here soon, I know Kaitlyn wants to see them!

xoxo Kim

We had a very nice weekend, knowing Hannah's counts were up we were able to have fun without the fear about risk of infection. Hannah's counts may be up, but her stamina is still very low. She went to school on Friday, and did very well although she didn't last the entire day. They called me about 2pm to pick her up, and I have never seen her so tired. She was really wiped out and looked exhausted. She came home and rested, had something to eat and we headed out to gymnastics to visit and show off Tod. We went to dinner afterwards with Tori and her mom, but Hannah was still pretty tired and wouldn't eat a bite. Wouldn't even eat the ice cream.

Saturday and Sunday we just played games, ran errands, went out to the movies and tried to keep Tod from once again peeing on the carpet. We think he had a break through tonight when all at once he ran toward the door, we let him out right away and success! Let's hope it's a trend. Hannah had been wanting to see the movie Fred Claus, so we went this afternoon. It was a good movie, and as Hannah describes it, "emotional at times". She and I were both crying. But it really got bad when, at the end of the movie, all the elves gather around the globe to look at all the children around the world opening the toys that they had made. It was very touching, but all I could think of was that "our" kids got cancer-what kind of gift is that? I had to try really hard not to completely lose it. Hannah didn't have cancer last holiday season. Let me rephrase that, we didn't know Hannah had cancer last Thanksgiving or last Christmas. Our holidays were like all of yours, with family, fun, food, thanks and lots of gifts. This year will be different. I think that THANKS will top our list. We have had a really *#$#@#& year, but we have so much to be thankful for. Cancer is not a gift anyone has on their list, but in some ways it is a gift. It is a gift to open your eyes to what really matters. It has changed our lives in so many ways, with so many wonderful people we have met, some new friends, some old ones and all of you so wonderful. Yes, this year will be different, and has been different beginning on January 30th at 1:00pm.

xoxo Kim

Good news today from clinic. We were very surprised to see that Hannah's counts were actually quite good, especially considering this is day 11 of her cycle, when she is usually very low. Her numbers were:

ANC 4272 Up from 73 on Monday (over 1500 is good)
WBC 6.89 Up from .306 on Monday (normal is 5-13)
Hemoglobin 12.3 Up from 7.61 on Monday (to be expected since she had the transfusion of blood on Monday)
Platelets 91.5 Up from 67.7 on Monday (a bit low, normal is 140-400)

Even the doctors were surprised at the turn around in her numbers since Monday, and Hannah was so happy! She will get one more shot to maintain her ANC tomorrow, just so it doesn't drop dramatically.

I had tried to prepare her for a stay today for a transfusion. I told her that this means that we will start her last round of chemo on November 26 and will be done by Christmas, HURRAY!!!!!! I can say that with certainly because once they start the round, they do not stop for low counts. Like she told Grandma, Grandpa and Aunt Susie today, "Well, we got lucky and my count was 91 which means I'll be done by Christmas".

Unfortunately that does not mean we can go on our planned trip to Grandma and Grandpa's for Christmas. Hannah's last chemo treatment will be December 17th, and she'll need a transfusion most likely either the day before Christmas or the day after. So, we can't be half way across the country. I know she will be disappointed, but we'll deal with that then, but we will be officially done, with chemo anyway, by Christmas. What a great present!

xoxo Kim

p.s. We may be thrown out of the hospital before then anyway, we are bringing Tod in next week, without anyone noticing of course, ha!

Yesterday was a pretty long clinic day, so I didn't get a chance to make an entry. Hannah's counts were low as expected. Her hemoglobin was under 8, although not terribly bad at 7.61, but considering her history and where she is in her cycle, they wanted to transfuse her with blood. I was expecting this since Hannah has looked terrible in the last several days, with no color, very low energy and dark circles under her eyes. This meant a long day since they first have to "type and cross" the blood-meaning check Hannah's blood including the antibodies in her body, with donated blood that has the same blood type and antibodies. They mix the blood in the test tube first to be sure there is no reaction before giving it to Hannah. All this means it takes some time before the blood comes up for transfusion.

Her ANC (white count for infection) was only 73. Even though she was on the shots, her count was still very low. I can't imagine what it would have been without the Neupogen shots. It has gone as low as 8 during this chemo cycle previously, and she is still on the way down, so she is still on the shots. We just have to be very careful right now about germs. She is home from school again this week and not allowed in any crowded areas or high traffic areas. We will pretty much spend the week at home.

We return to clinic on Thursday, which will be day 11 of this cycle. That should be Hannah's low point in the cycle, and I would guess that she will have to have platelets, and possibly another blood transfusion also. I'm hoping for just platelets because they only take an hour to transfuse, compared the the blood which has to go in very slowly at a minimum of 3 hours.

In the midst of all this, Hannah fell and hurt her foot on Sunday at the horse show. Uncle Mike was visiting for a couple days, and Hannah came with him, Tod and Dave to see Colby in the show. She tripped right when she got there and hurt her foot. There are no noticeable signs of injury, but it has really bothered her since then. At first she couldn't put any weight on it at all. Now she is limping around, walking very gingerly. They looked at it yesterday and said it looks fine, but if it's not better by Thursday, she will have an x-ray. I think it's just sprained. These pictures are from the show, Hannah with Uncle Mike and Tod-he blends in with the blanket but he is in there, and with Colby-who got reserve champion at her show and Dave!

xoxo Kim

I have managed to post Hannah's commercial that she was in for the Songs of Love Foundation here on the left hand side. It is a streamed link from YouTube, so if you have trouble viewing it here, please let me know and I can email you the direct link for YouTube. The commercial is only playing in the New York City area. I am still hoping to see it sometime on tv. Hannah has seen it and she said she doesn't like the part where they show her eyes moving to the side. I told her it's because she wouldn't look up during the filming of the whole thing! She was very tired, and had just been given a strong anti-nausea medication. I felt badly for her, at the time it was the last thing she wanted to be doing. But, she has listened to her song over and over and over and we love it! John Beltzer and his team do such a wonderful job and are so giving. It's a wonderful organization.

Also, here are some more pictures of Tod. Hannah took the two of him outside, and the other is of her giving him a bath today. We took him to the vet, and he is now on medicine for a cough, but he seems to be doing well overall. He weighs a whole 3.8 pounds.

Hannah had a quite a busy day today, taking Tod to the vet, doing homework and her studies, making a card for her classmates (with lots of pictures of Tod), giving Tod a bath and taking one herself. By 6:00pm she was overtired and crying. With her falling counts, her stamina is going down right now. She needs a nap, or early bedtime, or both, but overall she is hanging in there. She ate a little more today, though not up to what she was eating before chemo.

xoxo Kim

Tod has landed!

Here are a few pictures, yes he is really that little. We picked him up today and everyone was so excited! They couldn't have been nicer at the puppy store, and gave Hannah the puppy along with food, a leash and a collar. Riley is wondering what in the world has happened, but he has been very good with him so far. Riley is just so much bigger than Tod, that his idea of playing just knocks Tod right over! Tod seems to be holding his own, he is biting Riley as I type. They seem to like each other and there is a lot of licking going on.

Hannah slept until noon today, and then in bed again by 8:30 tonight. She isn't really eating anything, and is complaining of a stomach ache from the chemo. I hope this goes away within a couple of days. We also started shots again today in hopes that her ANC doesn't go to zero again this time, but we'll see. For now, we are lying low and staying away from crowds and germy situations. I'm sure Hannah will find plenty to do with Tod here.

xoxo Kim

Round 8 is officially over (at least the chemo part of it, the cycle is actually 21 days long, today is day 2). But, no more chemo until Round 9!!!!! We now only have our very last round of chemo left, pretty hard to believe. I have updated her chemo schedule on the blog, always feels good to add one more round to the "purple" side.

Hannah did ok today, she doesn't feel that well, her stomach hurts, she is very tired and her counts are headed south. You can tell by looking at her, that she's not up to par. She is sleeping now, and getting hydrated through tonight. I will deaccess her here at home tomorrow morning. It was nice spending the day with Kaitlyn and her mom Carolyn today in clinic. The girls were both there getting the same chemo (part of it anyway, for Kaitlyn).

We are going to be staying in for the next several days, as I know she is very susceptible right now to infection and we want to do everything we can to stay OUT of hotel Schneiders. The only thing on the agenda is TOD, and we will hopefully know more tomorrow. I don't know who is more anxious to get the new dog, Hannah or Colby.

xoxo Kim

We finally made it-but just barely! Hannah's platelets were great, going from 61 last Thursday to a whopping 244 this week. However, as I suspected, since we stopped the Neupogen shots, her ANC went back down. It was only 687 when read by the machine, which would have stopped us from getting chemo, but to get a truer reading, they calculated it manually and it was 807. Her ANC has to be at least 750 to get chemo (which, by the way, is still considered neutropenic.)

So, today she started Round 8. She is on at home hydration right now, to be sure the chemo is flushed out of kidneys so they are not damaged. Tomorrow, same thing, more chemo, then at home hydration again. This chemo is quite long, we have to wait until her urine is sufficiently diluted, then 1 hour for the chemo, then another 4 hours of hydration at the clinic. We left this morning at 6:30am and got home tonight at 5:30pm. With all the anti-nausea drugs she also gets, along with the anti-pneumonia drug today, she wasn't so happy. Or it could have been that this morning she ate two packs of Oreos, 5 bags of Doritos, and an apple all before 11am. That was it until dinner tonight when she ate a cheese tortilla.

I think Tod would have made it feel better, but I was glad he wasn't here with us yet. They said today we could pick him up on Friday after he has a full vet check this week, but we're hoping it's a bit sooner. We'll check with them on Wednesday. She wants to take him to clinic next week for her blood check, but considering the risk for a transfusion and a very long stay at any time, that won't happen (yet). We will sneak him in one day, he could easily fit in your pocket.

One exciting thing I forgot to note from yesterday. Someone mentioned that they saw Hannah's commerical for Songs of Love on television this past weekend. She thought it was either the Discovery Channel, or TNT so I have been browsing through the stations since then trying to catch it. She said it was wonderful and brought a tear to her eyes! I'm not sure if it is playing around the country, or just in the east but I will try to find out. The production company is sending me a copy so I will post it when I receive it, but I would really love to see it on tv!

Thanks for continuing to visit and lend your support to Hannah and our family. It means a lot that you have stuck with us through this long journey.

xoxo Kim

Tomorrow is our day, so let's hope Hannah's platelets are up over 100. The doctor seemed to think it should be up by tomorrow, so we'll see. Hannah will come home with her needle still in, and receive 12 hour overnight hydration. Then we go back Tuesday for another day of chemo, and more hydration Tuesday night. I will deaccess her myself on Wednesday morning. Keep your fingers crossed everyone!

So it seems the word is out about Tod (named after Tod-with only one "d"-from the Fox and the Hound). A local puppy store offered Hannah a puppy about a month ago. We have been visting shelters and the puppy store off and on for the last several months. Recently, the owner of the puppy store told Hannah that when she was ready, any puppy in the store was hers. Talk about excited, WOW! I told her that after this round of chemo, we would go and pick out a puppy. Last week she fell in love with a small puppy-he's a cross between a Chihuahua and a Boston Terrier-a dog that is small and stays small, which was her #1 request. I finally gave in and said it was time. We don't have it yet. We were due to pick it up today, but it seems the dog may be recovering from an illness, so the vet will check it out first before we bring it home, just to be sure. I will wait to post a picture until I know for sure. Hannah was very upset tonight when we didn't bring it home and cried the whole way home. We have already been shopping and have everything all set for the new addition to our family. So, stay tuned for more information very soon!

This weekend I did have the opportunity to attend a spa day at the hospital for moms. It was a very nice day, not so much because of the wonderful aromatherapy and massage, but because of the other moms I got to meet. I see so many children and their parents at clinic, but really do not get to meet or talk to them. I know them only through their children and their children's illnesses. I met Carolyn, Jean and Debbie and spent time just taking with them. When you are able to speak together about things like neutropenia, counts, ANC, hemoglobin, Cyclophosphamide, platelets, stem cell transplant, etc. without explanation it bonds you. It really is like another world, one that you never wanted to become a part of, but one now that I feel comfortable in. This world is now our reality.

More tomorrow, after our hopefully long day at the clinic (as Carolyn put it!)

xoxo Kim

No chemo today, unfortunately Hannah's platelets were only 61, and they had to be 100 to get the chemo. It's probably better anyway that her body has some extra time to come up and past 100, so that she is stronger before the drug totally collapses her again. We have an appointment for Monday, and expect that her counts will be fine to have chemo on Monday and Tuesday.

We all had fun yesterday trick-or-treating. Hannah made it to about 8 houses, before she tired out. Then I carried her for another 8 houses before I got tired, and she made it the rest of the way in style riding in the wagon. Colby took her bag around for her, so she still collected a lot of candy (just what we need, more candy!!). She is a great big sister and had no trouble carrying around 2 heavy bags of candy. I think Hannah got a bit bored in the wagon, watching everyone else run from house to house. She told me that it was not that much fun because she was too tired. I have to give her a lot of credit though, she didn't complain and was a trooper. It was hard not to notice the enormous disparity between Hannah in the wagon and all the other kids running around having a great time on Halloween. The look on her face was so sad and quiet and lonely.

Colby went afterwards with her friends and Hannah wanted to stop at two houses on the way home-the neighbor down the road that we don't know with a golden retriever, and our neighbors the Rohrbachs. We did both together and called it a night.

Here are a few pictures of us on Halloween.
xoxo Kim

Hannah had a good day today, made it through a good part of the day at school. I picked her up at 1pm. She ate a good lunch, then rested a bit before we started making cookies to take to clinic on Thursday. Hannah is going to dress up like a chef and hand out the cookies. She really wanted to SELL them and put the money in Cans for Cancer, but I convinced her that giving them away this time would be best. She said when I turned my head, she would be selling them, ha!

Here are a few pictures I couldn't get to post yesterday, wanted to share them for the weekend. We kept Hannah pretty sheltered this weekend, considering her low counts and fatigue level, so things were pretty low key.

With Colby and their friend Emilie (and Hannah's surprise cake),



Out walking the dog yes, she's in there


With one of Grandma and Grandpa's huge pumpkins they brought from their own garden!


xoxo Kim

Again, mixed results from our clinic visit today. All of her counts were up some except for the hemoglobin, which was down. So, we had to stay for a red blood transfusion. This is the long one. We left the house at 7:30am this morning and got home at 7:30pm. It takes 3 hours to transfuse the blood, since it has to be done very slowly. It also takes a while to get the blood upstairs, it has to be typed and crossed to be sure it matches Hannah's blood and all the antibodies too. Our appointment today was at 10am, they started the transfusion at 2pm. Hannah got in a couple good naps, so that was good!

However, her platelet count was only up to 34 (from 11 last week). Her platelets have to be up to 100 to get chemo this week, so the doctor said to expect a delay. Another delay. We are creeping closer and closer to that Christimas date. Frankly, I can't see any way that we will be done before Christmas but I don't want to tell her that yet. We'll just keep on going because one day it has to be over.

Hannah has been having foot and leg pain when walking. It started last week, and at times is pretty bad. She is limping quite noticeably and it hurts to walk. The doctor today said it was probably due to the Neupogen shots she is getting every day. She has been on it for quite a while now. She got a shot today at clinic (although she always makes me give it, even at clinic) and will get one more shot tomorrow. Her ANC is pretty good, so hopefully this time when we stop the shots it won't drop again until after treatment. I did notice today that when I went to give her the shot, they had prescribed more than twice the dosage she has been getting at home. It was still an acceptable dose for her, but it was the WRONG dose. Again. They had prescribed an acceptable dose for her, but didn't check what she had been getting. They changed it.

Going to try school tomorrow and see how it goes. And, oh yes, Way to go Red Sox! Do you want A-Rod?

xoxo Kim

We hit the clinic today, with the anticipation that they would discontinue Hannah's Neupogen shots and that we would be clinic free until chemo next Thursday. When the doctor arrived, she said Hannah's counts made a "big jump" from last week-unfortunately they were all down, way down. I was so surprised and not expecting it at all, considering that last week the doctor said her counts were on their way up, shots went to every other day and all looked good. Here are her counts:

WBC white cells- .666 (should be 5-13)
ANC- 211 (should be 1500-8000, under 500 is severely neutropenic)
RBC red cells- 2.75 (should be 3.9-5.3)
HgB hemoglobin-8.36 (should be 11.5-16, transfuse RBC under 8)
Platelets-11 (should be 140-400) dangerously low

I did notice today on the way into clinic that Hannah's teeth were bleeding, but she was eating an apple so I didn't think too much about it. I also noticed the large bruise on her leg from the shot last night, bigger than usual. Both of these are warning signs for low platelets-they are the part of the red blood cells that clot your blood. But, when she got her finger stick today, he had to work to get the blood out, so I thought the platelets were most likely fine. WRONG.

Just when you think you you have a handle on how her body reacts to chemo, things change. I can't seem to predict this at all any more. We were not prepared mentally to stay today. Hannah had to be accessed, and she was not happy about that. And, not being prepared we didn't have Hannah's new beach glass necklace (which we absolutely loved Behr family.) It will definitely be with us next time. At least the platelet transfusion only takes 1 hour (from the time they start it, you have to wait for them to be ordered, delivered and prepared). A blood transfusion takes much longer, 3-4 hours-we would probably still be there.

So what does this mean for her treatment next week? We don't know yet. We have to go back to clinic on Monday to get her counts rechecked. Hannah will also stay home from school tomorrow-her counts are just too low to be around other kids and she will probably be too tired anyway. Here are a few pictures from clinic today that we wanted to share with you. Hannah's typical day.

Our first stop at clinic is with Rob. Rob does all the finger sticks and it's the first stop for all kids coming to clinic. This is the small amount of blood they take to check her counts. It takes about 30 minutes or so to get the counts back. Rob is a favorite with Hannah. p.s. notice the Boston hat.



Next we go over to the next room for blood pressure, weight and temperature. This is the easy part of the visit.




Then we are back over to the first room to get accessed. Hannah insisted no pictures during accessing, and since she always sits on my lap for that with me holding her hands, that would have been impossible anyway. Here is Hannah getting her blood pressure and temperature taken at the start of her platelet infusion.



Then we will skip right over to deaccessing.

Here is Hannah flushing her port herself. Doesn't she look proud here?

And lastly, Hannah with her favorite nurse Antoinella. Hannah decided today that she would no longer be mad at the nurse who accessed her, but instead she would be mad at the doctor who ordered it! Yes, she came up with that one all by herself.


xoxo Kim

I'm so excited, the Red Sox are on........ho hum..........

Seriously, we have a split household right now, with Hannah and I rooting for the Red Sox and Colby and Dave rooting for anybody but. Hannah said she's wearing her Red Sox hat tomorrow, which is pretty risky, considering we have a clinic appointment in the heart of Yankee country. I guess when you're 8 and bald you can get away with pretty much anything.

The girls carved pumpkins last night, although no one touched the "inside yucky stuff" except mom. They were hard at work and look how great they came out! I have to take a picture without the flash so you can see how nice they look all lit up.

Tomorrow we have clinic, so hopefully Hannah's platelets are up from last week, so that she can get her next round of chemo next week. She is also still on Neupogen shots, so we also hope they stop those tomorrow.

This weekend our family is heading to New York City for a pumpkin festival and walk through central park. The event is sponsored by the Pediatic Brain Tumor Foundation and the Sunrise camp for cancer kids to raise money. Hannah is going to donate money from her cans for cancer fund. We hope that the weather holds so we can attend! I'm sure we'll have lots of pictures to share from that. We are all looking forward to participating.

xoxo Kim

Another busy weekend since Hannah is feeling good and her energy level is pretty good. Saturday was Rally Day at the 4H. Here is Hannah with her purple team and Hannah on Finessa. All riders were split up into teams who then competed against each other in fun. I was a bit apprehensive with her platelet count down, but everything was fun and safe. I ran alongside Hannah during the day to be sure her horse didn't get any ideas about running off. Having said that, a few girls did actually get thrown from their horses. No-one was hurt, thank goodness, but it's still scarey to see. That's the thing about horseback riding, you can be a very good rider and still get thrown if the horse decides (which is why I'm always on the sidelines wringing my hands until each lesson is over). Colby and I spent the rest of the day traveling west to her basketball game, while Dave and Hannah came home, took a trip to the library to pick out new books with Mrs. Baker, hit some tennis balls and hung out with Riley.

Today Hannah went bowling at Mary Kate's birthday party, then came home and drove in to her dad's gym to go swimming. There is an indoor pool there that they like to go to. She was planning on having ice cream when she got home, but said she was too tired. She still gets fatigued at the end of the day, but has no trouble right now making it through the day with lots of activity.

We go back to clinic on Thursday for a recheck on her counts, hopefully her platelets will be up by then and her ANC will be ok so that I can stop giving her the shots.

Thank you to all of you who have supported Hannah in her Cans for Cancer campaign. So far she has received donations from friends in 4 different states! Thank you so much.

Hannah was at clinic today to check her levels. She was so funny when we were walking in she asked if she could watch a movie after we saw the doctor and I said "we are leaving after we see the doctor." She smiled so big and said NO CHEMO? It was pretty funny, and she was so happy.

Her counts were good and bad. Her ANC (for fighting infection) is good, but her platelets (for clotting your blood) were pretty low. They were not quite low enough to transfuse, but not far off. We just have to be careful in the next week not to do anything that would risk bruising, which could cause internal bleeding. He said horseback riding was ok on Saturday as long as Hannah didn't do anything too risky, walking and easy trotting are ok. We go back next week for another blood check, but we expect to be ready for chemo on Nov. 1st and 2nd. The doctor made the decision today to do her next round of chemo the day after Halloween, rather than on Halloween (another happy thing for Hannah today).

Next week when we go to clinic, we will also go for a renal sonogram. Her last MRI showed a cyst on her kidney. They think it's nothing, but wanted a follow up with a sonogram to be sure. We will follow this to be sure it's nothing.


Grandma and Grandpa went home today and we want to say HAPPY BIRTHDAY to Grandpa. We celebrated with him last night, here are a few pictures from the celebration. My parents have been so incredibly supportive and important to us in this, we couldn't have done it without both of you! We hope the next time we see them is in Indiana, rather than here again for another round of chemo.

We also want to say hello to our cousin Noah in Illinois who had to spend a few days in the hospital lately getting his appendix out! We hope you're feeling better really soon. We would love to go fishing with you again this summer at our next family reunion.

xoxo Kim

The link to Hannah's Song of Love is now working, just click on the play arrow on the sidebar to your left to hear Hannah's Song. I will post the words later.....

We got released today with no issues and are happy to be back home. Before leaving, Hannah got a flu injection to help protect her this year against the flu virus. Our entire family now has been vaccinated and it just shows who the wimps are!!

Hannah is on Neupogen shots again so that her levels don't go too low. She is also on two anti-nausea meds for this week, instead of the normal one. She did really well this round, with minimal bouts of nausea and no vomitting, although the ringing in her ears is already back. It did go away last time after this medicine, took a couple of weeks.

It was a very difficult admission for us this time, regardless. The floor was packed with patients, we had to move rooms once due to issues and Hannah also received the wrong dose of medicine two days in a row before it was caught.

You didn't read this incorrectly, she was overdosed, again! I won't go into a lot of technical detail here, but she was given 10 times the amount of diuretic medicine on Wednesday and Thursday with her chemo infusion. The nurse noticed it after the dosage was written differently (correctly) when it came up from pharmacy on Friday. It wasn't an easily identifiable mistake, and even though I check each dosage myself, it was very complicated to figure out and even harder to notice. It wasn't like the medicine bag said 10 grams and the dose should have been 5 grams.

We knew when the attending walked into our room on Friday night at 7pm that something had to be wrong. They don't just visit. Fortunately, all of her levels checked out, and it did not adversely affect her because some of the side effects of overdose of this medicine are quite serious. Thank goodness it wasn't the chemo, or we would be in a different situation. Doesn't leave you with the best of feeling.

But, Round 7 is complete, and we are looking toward the future. Hannah is going to school tomorrow although not that excited about it (it goes without saying that she would rather be home with Grandma baking cookies all day). I hope she can stay for the day, but we'll see. We go back to clinic on Thursday to check levels again.

Thanks to all for the cans that have been dropped off. The first thing Hannah did when we arrived home today was run over and check the bins for cans, and wow, there were lots!

xoxo Kim

Today is Friday, Day 4 of this 5 day chemo round. Yesterday she didn't nap at all, and even stayed up to watch Survivor! We try to stay busy during the day with crafts and games and movies. She doesn't like to do too much moving around because of her needle and the IV pole. Her eating is not great, but not terrible. She gets in some rice, rolls, soup, poptarts and of course a bit of candy too.

Grandma and Grandpa came up today for a visit. The brought some new crafts and a nice packet from Mrs. Grossman, Hannah's art teacher. Here is Hannah with her beautiful horse picture she colored. Mrs. Grossman always sends the best goodies, thanks! She slept today for all of about 10 minutes before the doctors came by on their rounds. Hannah is doing well and her counts are good, drifting down a bit but not crashing.

The Smiles for Scott Foundation just brought around the candy cart, so that's always a fun time. Hannah told the nurses at school that she would bring them something, so the cart came back for a second round and Hannah got something for each of them. I don't know if I mentioned before that the Foundation sent Hannah a nice thank you note after we donated the money from her bake sale. Then, a couple weeks after that we received a beautiful plaque from them also, which was personalized for Hannah and specifically thanked her for holding the bake sale for them. We were so touched by it. I spoke quite a bit with Scott's mom today, it's been 2 years since her son Scott died from medulloblastoma. She said Scott was in this room that Hannah is in for quite a while-although he was in it by himself. I'm not sure I could be back here like she is. She said she still hears the beeps of the machines at night and really can't go into the bone marrow transplant unit (where Scott was for quite a while also.)

So we are stocked for candy now, and Hannah is taking a rest, or at least trying in this very noisy room. We'll leave you this picture of Hannah getting her chemo, still smiling.

xoxo Kim

We're settled in now, second day of chemo under our belt. Hannah is doing well. She was eating well today until this afternoon, and has not eaten anything since, doesn't even want chocolate. She has been in pretty good spirits though, but she cries about once a day that she just wants to go home. Only a few more days I tell her.

We did have some excitement today. Hannah was chosen to be in a commercial for a company called Songs of Love. They are a non profit company that creates unique songs for chronically and terminally ill children. We filled out an information sheet, and they included everything in her song from family and friends names to favorite sports, animals, etc. The Childlife people here were asked to recommend a child and they thought of Hannah. She agreed to do it, so today a film crew showed up to make the production. The commercial will be aired on cable channels, and is intended to get people to donate their old cars (and money too) to the Songs of Love Foundation, so that more children are able to receive songs.

They brought with them Hannah's song, which we had not heard yet. John Beltzer is the creator of the foundation and the singer/songwriter and a very nice person. The Song of Love Foundation has been featured on the Rosie O'Donnell Show, Today Show, CNN, Black Eyed Peas concert, CBS with Dan Rather, and in People Magazine and much more.

John tried to put Hannah at ease while the crew set up everything, but you know Hannah she is pretty quiet around people she doesn't know. It was like being on the set of a big production! They did the takes over and over, and Hannah didn't have to speak much. When they asked her what she thought of her song she said "it's good." Little did I know that I would also be in the commercial (or I probably would have opted for a shower today!!!) She held up well, but was very tired from some of the medicines they had given her earlier. I wasn't sure if she would make it through, but she rallied! It will be interesting to see how it all comes together (I hear Dan Rather will be in it also from his earlier interview). I will post it here if I can do that. I will also post Hannah's song-again, barring any technical difficulties. Here is a link to their website, if you are interested in seeing all they do. Click HERE

Here is a picture of Hannah after the crew left, she fell asleep about 3 minutes after everyone cleared out.

xoxo Kim

Yes, we're in! Hannah's counts checked out today and we were admitted for Round 7. It took ony 10 and a half hours to get upstairs on the floor into a room, ugh! We got here at 8am (left our house at 6:15am) and didn't get in our room until 6:30 pm tonight. It is very packed here, and every room is full. There were three admissions today, and we were the last to get a room. But, now we are in and settled. They started Hannah's chemo before we came up to the floor, so she was even done with both of her medications by the time we arrived. So far, so good, just fatigued from the 2 anti nausea meds, and still eating well.

Hannah was able to deliver the gifts she bought today to Childlife. They were so happy to receive everything. This is a picture of Jan from Childlife receiving the goods. Since we brought them directly to Childlife, they are able to use them specifically for the hemotology/oncology pedicatric patients that are either in clinic or inpatient. Hannah is going to ask them to break out the Mousetrap game we brought tomorrow!

Hannah also feels the need to mention our Yankees. She told me that now she will root for the Red Sox because the Yankees aren't in it anymore. Just two nights ago when Johnny Damon hit a homerun to lift the team up and begin a rally to win the game, she was insistent that we email Audrey from Spaulding in Boston (who loved Damon before he became a Yankee and cut off his hair). Not many people we know switch from rooting for the Yankees to backing the Red Sox, so to all of our Boston friends, good luck!

Hannah's Cans for Cancer reached a total of $357.50 as of today. Since we are anticipating being admitted tomorrow for chemo during the week, Hannah wanted to go out to do some shopping (one of her favorite activities) to get some supplies for Childlife at Schneiders. Here is a picture of her with a trunk full of supplies. She did very well, and still has some money left over. She got so many things like play dough, markers, glue, many games, batteries, blocks, books, dvds, and so much more! We are going to ask them next time for some of their specific requests to ensure we're providing exactly what they need. We went with Grandma, and she and Colby had a great time searching for what they liked. She can't wait to hand them over to Jan and Faye tomorrow!

Thank you to everyone who has helped the cause. We really feel we're making a difference and maybe for a moment are easing the burden of the children with this terrible disease. We can tell you first hand that when you are stuck in clinic for hours getting chemo, or inpatient up on the 4th floor, this is all you have to occupy your time. Even the children who aren't feeling well enough to go out of their rooms enjoy watching a video or playing a game with their mom or dad in their room. We are all making a difference together, thank you so much!

We will update tomorrow from the hospital, hopefully counts will be good enough to stay!

xoxo Kim

Today at clinic was not what we were hoping for, but not entirely unexpected. Hannah's ANC was only 547, and it has to be at least 750 to begin a new round of chemo. I was somewhat surprised that her doctor did not put her on the neupogen shots to boost her ANC until the next round. The reasoning was that she would only get a few days of shots in before they would have to be stopped 48 hours prior to chemo. Since they don't do routine admissions during the weekend, the earliest she could be admitted to start would be Monday, and we're already scheduled to start next Tuesday. He figures she is on the way back up now, and her body can come up on it's own by Tuesday, so why put her through the shots. They are not a guarantee anyway.

So, Hannah walked out today pretty happy. No accessing, no hospital and no shots! We really don't want her treatments delayed, becuse the chemo is precisely scheduled to be most effective. The longer you get away from that schedule, the less effective the chemo becomes. We are hoping for no more delays. The doctor did increase her appetite stimulant medicine because she has not been eating well over the past 2 weeks and that is going to get even worse as the chemo progresses in the next 3 rounds. She has lost weight the last two visits, and while it has not been a substantial amount, we don't want to see that trend continue.

For the rest of this week, no clinic visits and no treatments. She won't go to school tomorrow due to low counts. We were home schooling today after chemo anyway, and already have the homework for the week, so we'll play it by ear for the rest of the week. I would like her to go to school to keep with her routine, but also don't want to risk an infection prior to the next round. She is also quite tired, her hemoglobin is low, but not dangerously so, and she is sleeping quite a bit. She'll have the next several days to rest up.

xoxo Kim