Leukemia Journal 2: Meds!

Days since Charlie’s diagnosis: 6

Charlie takes a lot of strange medicines.

First and foremost are the highly toxic chemotherapy drugs that target and destroy cells that reproduce quickly. Since Leukemia cells are very rapid dividers, these chemo drugs are very effective at making Leukemia cells explode all over the body. When these Leukemia cells explode they release their contents into the bloodstream, which can wreak havoc on the liver and kidneys, so Charlie has to take medicine to flush all this stuff out of his body quickly. Blowing up all the naughty cancer cells and flushing them out is the primary way the doctors plan to put Charlie into remission. Of course it is a bit strange to see my toddler taking cocktails of medicine that is so toxic the nurses wear full body protective clothing any time they handle the stuff. But really what choice do we have?

Charlie also has to receive a lot of fresh blood and platelets just to stay alive. This is because Leukemia cells crowd out the hemoglobin (and other helpful things) in the blood, which essentially renders one’s blood unable to process oxygen or fight against bacteria. When we brought Charlie into the Emergency Room last week, he was in the process of dying from this. The constant infusions do not fight the underlying problem (too many Leukemia cells), but instead they stabilize Charlie so he can stay alive long enough to receive the chemo (which does fight the underlying problem). At first all this blood was more liquid than Charlie’s little body was used to (his heart had grown accustomed to working with scarce resources), so some of the liquid backed up into his lungs and gave him a wet cough that kept him up all night. But more recently the blood has clearly recharged Char and brought back a lot of his former strength. He’s been joking and acting silly these past couple days, wiggling around the bed and getting up to come sit by the window. Seeing the smiles, watching his personality bloom again, seeing him have the energy to eat and chat and laugh… it’s been so very precious. Gotta live in the moment these days.

And then there’s the steroids. Steroids are a big part of the treatment because they help the chemo more effectively destroy leukemia cells, and they reduce the allergic reaction the body has to toxic chemotherapy drugs. Char is getting roided up, so of course he periodically experiences roid rage (roid rage + moody toddler = ridiculous behavior). Even without the steroids, who wouldn’t be mad at being trapped in a hospital bed for days, feeling depleted and yucky and weak, pumped full of strange meds that make you feel weird, poked and prodded by strangers all day and night? From my perspective, it’s very tough to see my little baby suffering with these weighty problems. He’s being given a course in resilience right now, but he’s still so little that I’m not sure he’s ready for such a lesson. But ready or not, here it is.

Tomorrow Charlie will get his second of many spinal taps, where the doctors will check his spinal fluid for Leukemia and inject chemo into his spine. When I type it out it all sounds so wrong, so cruel, so backward. But if we don’t do this thing, the leukemia cells will continue to overwhelm his body (no matter how much fresh blood he gets), and he will die from it. So he’ll take all the chemo drugs, and fluid flushing drugs, and anti-nausea meds, and steroids, and spinal taps, and fresh blood, and other things too, because that seems to be the only road to a cure. The American Cancer Society says that with the new drugs and treatments available today, “the 5-year survival rate for children with [Charlie’s sub-type of leukemia] has greatly increased over time and is now about 90% overall.” In a strange way, that makes Charlie lucky to have gotten this cancer instead of another one, because the doctors at Stanford know how to kill this disease. It can be done by giving my baby a whole big bunch of poison for a long long while. So that’s what we will do.

Side note: Erica and I have been rotating in and out of the hospital each day, so that one person stays with Char at Stanford and the other person stays home with Jack (who is not allowed at the hospital due to Covid). A massive rain storm pummeled the whole Bay Area all day, knocking out the power in our home from 7am all the way until 8pm or so. It’s my night at home, so Jack and I sat there this afternoon watching our house grow colder and darker as the hours passed, sat there in the gloomy and quiet house, listening to the violent storm, thinking about Char and the strange, eerie quiet, and how not too long ago it was summer and we were all out on the open road camping and exploring and being noisy and living life. I know that summer will return again in the future, and that Charlie may in fact heal and go on to live a long and happy life, that there are real reasons for hope, and that we are so blessed in so many ways…. but tonight, when the rain is pounding and the house is so cold and Charlie is so far away, and I know that tomorrow Char won’t be able to eat all day because of his procedure, and that he’s going to be so miserable and confused, and that he will face so many hard days coming up… when I think about that stuff, well, I just get pissed off.

Leukemia Journal 1: The Beginning

Days since Charlie’s diagnosis: 3

My son Charlie (age 3) has leukemia. We found out three days ago. He was lying in his bed all day long, not wanting to move, not eating, just looking weak and miserable. We video conferenced the doctor, and she said go to the ER. We got to skip the waiting room and go straight to a doctor, as if every medical professional that set eyes on him could tell something was seriously wrong. They drew blood and came to tell us, with absolute certainty, after one look at his blood, that he for sure 100% had leukemia. They could see the leukemia cells right there in the microscope.

Charlie has been exceptionally brave and stoic throughout this ordeal. He’s already been poked and prodded and examined and checked at all hours of the night, tied to tubes and wires, stuck in a bed in a strange place far from home, surrounded by strangers, feeling sick and exhausted and confused. Yet he’s still his goofy self, especially as the treatment starts to give him some energy back.

The first step was to stabilize him by giving him multiple blood transfusions. Those aggressive leukemia cells have been crowding out the other cells in this body – like the ones that carry oxygen to the brain or fight against bacteria – leaving him weak and sick. So the doctors started by giving him blood and platelets to bring him back up to baseline so that he would be well enough to begin chemotherapy. And it really did work; he really did have his energy back today! He was cracking jokes and making silly faces and pretending to be a doctor. Watching him play and be silly reminded me that he has been pretty lethargic for the last month. Now it makes sense why our energetic boy was suddenly so tired and fragile all the time, why he had stopped running or riding his bike, why he just wanted to be held all day.

Today he also took his first dose of chemo. If I am not mistaken, he will now continue to take chemotherapy medication for the next three years. The doctors (here at Stanford) seem to be preeminent experts in treating this very illness, so it appears we are in the best possible hands. They are kind and confident and experienced. I am attempting to find hope in their confidence.

When Charlie is frustrated or confused or in pain, I find it very challenging to stay strong. When I have to wake him up at 4am so a nurse can poke him with a needle, or when he can’t leave the bed for days on end, can’t cuddle the same way or see his brother, when his confusion and pain turns into rage…. that’s when I feel my facade slipping. Charlie needs us to be strong and confident like the doctors are, but sometimes the fear is overwhelming. Fear that we will lose him. Fear that the way of life that we loved so much (before he got sick) is gone forever. Fear that he will be in pain every day for a long long while. Fear that he will never get to live a life, that it will be taken from him, that he won’t understand why, that he will suffer for a time and then be gone forever.

But dwelling on this fear does not seem to carry any benefit. Yes I need to plan for these contingencies, but already I can sense that the fear and sadness are not beneficial emotions, as natural as they might be, They do not clarify my thoughts, nor do they help me navigate difficult moments better. I do not necessarily believe that suppressing the fear and sadness is beneficial (and I am not a trained therapist); I am only observing that I do not find those emotions particularly helpful while I’m down here in the trenches. If they could be gotten rid of, this process might be much more manageable. Charlie is clearly feeling a lot of fear, and wouldn’t it be nice if I was confident like those doctors, so that I could absorb his fear and help him feel secure and supported. Is this possible, is this wise? I don’t know, everything is still so new. It has not yet sunk in that this is our new life, our permanent life. Once that sinks in, once Charlie survives this first month, this first year, maybe the fear will go away on its own.

We can do hard things.