He climbed onto his brother’s bike, said he could do it without help, and rode away down the sidewalk. Chase –once watched anxiously to see if he’d ever walk and talk after major brain surgery– rode a big kid bike today!
The determination of this child never ceases to amaze me.
On our way to Chase’s 18-month post-radiation appointment. 18 whole months since he last whispered “I’m so brave…” and we wondered if this treatment would work and if the cancer would ever clear from his spine.
As we drove, he stared out the car window into the cloudy morning and said: “Mom, one day, I’ll be as tall and strong as the trees.“
We had a precious morning with these people who were only meant to oversee his care, but became dear friends instead. Rejoicing in the life given…
It’s so beautiful how the small mercies are everywhere.
Chase had an incredibly early surgery time which allowed us to avoid traffic (as much as you ever can avoid traffic in Chicago…on a Friday…during construction season…)
Only the most important part of the day: picking the pre-op movie
The anesthesiologist on duty today has worked with Chase multiple times and knows his preferences well. In fact, this doctor was the same doctor who administered anesthesia on Chase’s final day of radiation (December 12, 2012) and he still remembered Chase and the party at the radiation center. This doctor always carries a mini iPad with him to distract children going into the OR which meant Chase was so busy playing “Fruit Niinja” that he barely noticed us as we parted. (This is what we want, right?)
In pre-op with our anesthesiologist and the mini iPad
The surgeon assigned to Chase was actually one of the few at Lurie who hasn’t placed a central line for Chase. Okay, maybe that’s a slight exaggeration, but when the doctor walked into the room and said “I see that several of my colleagues have worked with Chase…”, suffice to say Chase’s central line history preceded him. He told us that there can be complications to removing a port – like the tube being stuck in the muscle – but today, there were none.
Heading into surgery with the doctors
Chase’s oxygen saturation levels dropped slightly after surgery, but he remained stable (with a little help from the oxygen mask) and awoke well.
Getting a little fresh air in post-op
The peripheral IV (which has always been placed in his thin-skinned, often bruised arms) was placed in his foot – making it that much easier to remove and giving his arms a break.
Clean it and stitch it and mark it with…steri strips?
And when he sat up to leave in recovery, he placed a hand across his chest -as if to both protect and feel the change-, looked at Bob and me, and said: “I’m free!”
At last.
Goodbye, dear port. We’ll miss you, but not really…
“The general protocol is that after six months of clear scans, we remove the port. …even for the ATRT kids. And as I look at Chase, I don’t see any reason to make an exception.”
We took a moment to absorb the words our attending doctor was speaking. Even with the concern of relapse and all that comes with an ATRT diagnosis, the port could and should be removed.
Changing the dressing on a Hickman – Winter 2013
This small piece of foreign material currently embedded in Chase’s chest has somehow come to both symbolize and encapsulate the last two years. It was the first thing in and will be the last thing out. We’ve had it placed, and replaced…and re-replaced again…and again. We’ve fought to keep it, repair it, and protect it. We became trained and comfortable in the procedures to sterilize it and triage when there was a problem. It was a picture of the need for chemo, yes, but it also provided life-lines of blood, platelets, fluids, medicines, and even nourishment when he could not eat.
What happens when the pressure cap falls off a central line…
His access has at times been on both sides of his chest and in both arms as well. It’s been a double lumen Broviac Hickman, a PICC, and a port. It has inexplicably infected multiple times, been infiltrated by a deadly chemo, cracked and broken and once, even slipped out as he turned in his sleep.
A cracked line…
Chase’s first and shortest Broviac was placed on August 16, 2012 when he was only 2 years old. He doesn’t remember a time in his life when he didn’t have either tubes coming out of his body or an access point for the tubes embedded under his skin. In it’s own way, it’s become part of his body and his identity, so when he was told that it was to be removed, he became very angry and questioned whether the doctors were going to remove his skin and bones as well – so much is this small device a part of him.
In pre-op for another port surgery with Nurse Jen
This constant access to his body was in some ways the craziest complication of his treatment months, yet a complete blessing too. But now it’s time for the last remnant of the chemo chapter that can be removed to be separated from his body. No more flushing it and locking it to keep it clean. No more crash kit with clamps, swabs, and gloves in a bag that goes everywhere Chase does. No more ER fever guidelines. When he goes in for MRIs or labs, he’ll require a peripheral IV…just like a “normal” child. A scary and wonderful thought.
What it looks like when the port needle slips and the fluid infuses into the skin around the chest…
He has equally fought it and protected it, and tomorrow, Friday, June 13, he’ll go into an operating one more time and they’ll open his chest and cut it out of the muscles into which it has been so carefully sewn.
We so appreciate your prayer as Chase undergoes this surgery and as we close this chapter. An oddly bittersweet… moment by moment.
“Have I not commanded you? Be strong and courageous. Do not be frightened, and do not be dismayed, for the Lord your God is with you wherever you go.” Joshua 1:9 [Chase’s favorite verse to say -often again and again- before he goes into surgery]
A moment of rest after a port removal and a PICC placement – lines all over his body
We sat in the room for almost two hours and dialogued on how the brain works. Chase fell asleep in my arms as Bob and I sat with the epilepsy specialist, discussing the EEG results and asking our questions. The human brain is an amazing place; full of energy and a fragile balance that the slightest thing can disrupt at any time. Marvelous and scary.
Despite Chase’s anti-seizure medication having some issues, after two hours of discourse and answered questions, we were counseled to stay the course. We were told that Chase’s brain was still too close to it’s trauma and needed to be protected from itself. Because Chase’s behavior was stable, we were to stay the course, increase his vitamins and call in three weeks to follow up.
[We were also re-briefed and updated on monitoring for any sort of seizure and the actions we should take if we ever observe anything. This included a seizure crash kit of sorts that travels with Chase at all times…just in case.]
May 2, 2014
Three weeks came and went and even with the extra vitamins, the aggression issue didn’t seem to improve at all, so, despite the continued need for neuro protection, the specialists conferred and decided to try reducing the anti-seizure medication. It’s only the tiniest bit (literally only a half of a milligram on one of the two daily doses), but over the last four weeks, we’ve seen a little improvement!
We’ve had some really encouraging, productive conversations with his teams of doctors and are feeling heard on this issue, however, there’s still much left to understand. Nobody knows for certain if what we’re seeing are the effects of medication, or radiation, or tumor, or being forced into an adult life at age two. The one thing we know is that whether we’re in a hospital room with specialists or in our home, with our family, working through a difficult moment; pursuing answers will be a marathon; not a sprint, and only time will prove…
We would so appreciate your continued prayer for wisdom and discernment as we continue to approach who Chase is and how to best care for him in all his facets of this special life.
Moment by moment.
Hear me, O God, when I cry; listen to my prayer.You are the One I will call when pushed to the edge,when my heart is faint. Shoulder me to the rock above me. For You are my protection,an impenetrable fortress from my enemies. Let me live in Your sanctuary forever; let me find safety in the shadow of Your wings. Psalm 61:1-4 (The Voice)