A day in Mac’s Life: AML

“Therefore we do not give up. Even though our outer person is being destroyed, our inner person is being renewed day by day. For our momentary light affliction is producing for us an absolutely incomparable eternal weight of glory. So we do not focus on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal.”

‭‭2 Corinthians‬ ‭4:16-18‬ ‭HCSB‬‬

Today has been a lot of information head on, like I had signed up for a CME (continued medical education), not realizing it was not just a slide show,  and now I was just getting so much information head on. Have you ever had so many questions it was hard to keep track?

So today went a little like this➡️

Labs were redrawn because the small amount of bone marrow did show blast, so that goes back to the potential diagnosis of AML. 

*FISH and chromosomal studies to be done

*buccal swab to be performed 

*The thought about these specific genetic markers is to determine if Mac’s leukemia has any unique markers. If it does that mean treatment may change a bit. 

Transfusion of blood occurred due to drop in hemoglobin and hematocrit. He will also get a specific type of blood  because his neutropenic state. 

Results are in:

Flow cytometry from blood drawn this morning, along with re-evaluation of the biopsies by three pathologist, shows blast. 

AML

He will have to receive intrathecal chemo, as the MRI, showed involvement of brain. That will start tomorrow following the LP. 

He will be started on first cycle of chemotherapy tomorrow as well. 

Because he is so young one of the medications that has been used in past, and is fairly toxic to the heart and can cause secondary cancers. So they are doing a different combo that has no effect to heart. 

Mass in groin will have to get focused radiation. Additional small masses in scrotum, pending urology consult and review of MRI. 

Following rounds of chemotherapy his numbers will be low and he will be in a neutropenic state. Which means higher risk for infection. Also a concern for losing weight as the chemo affects his mucosal membrane. He may not want to eat, so there will be discussion for G-tune placement. 

Once in remission, his siblings will be screened for possible stem cell transplant via bone marrow.

Vitamin D: yes. Mac is exclusively breast fed

Iron: yes, but since he just was transfused he won’t need

Allopurinol: to prevent the increased uric acid, caused by chemotherapy 

Probiotics: not at this time

Vitamin C: not at this time

Antibiotics: will see if continuing current regimen is needed. Once at home will have to be placed on prophylactic antibiotics (levaquin); Bactrim on weekends (help prevent pneumocystis pneumonia which is common in kids receiving chemotherapy)

Vaccination: I had not vaccinated Emerson with everything going on. Suggested to possibly get some vaccinations on board. May give some protection, but most kids who were previously vaccinated have to be revaccinated following chemotherapy. So I’m going with my gut/doctor feeling to hold off. 

  I kept thinking about is what is my hope in? Who am I trusting in: myself, the doctors, my family, friends? Jesus. That is the recurring answer at a small group I’m a part of. He is the only answer, I can’t live without Him, how about you?

Enjoy: https://youtu.be/nCqIKzFCtg4