Maintenance.

We made it.  September 16, 2010, Gabriel started maintenance.  We are now one giant step closer to the end.  The journey before us is still long, but we’ve survived the hardest part.  We have crossed that line in the sand.

The word itself doesn’t sound like much.  But, truly, this is a monumental point to have reached.

The maintenance phase of treatment for Acute Lymphoblastic Leukemia is pretty much the same whether it is pre-b, t-cell, or what not.  It is a repeating 84 day cycle that continues for basically 3 years for boys and 2.5 years for girls, based upon the date that the child begins the phase “delayed intensification.”  So, for Gabriel, that means, on April 27, 2014 he will take his very last dose of Chemotherapy medications and on April 28th, he’ll be done with his treatment.

Chet and I are adjusting to a new “normal” now. Once every 84 days he gets a LP (lumber puncture with intrathecal chemotherapy). Gabe is on a daily oral chemotherapy medication.  Weekly he gets another oral chemotherapy medication.  One week every month he gets oral steroids. Twice every 84 days he gets I.V. chemo therapy.  And for the first three cycles, Gabriel will spend 5 days in the hospital when he is given the clinical study drug, Nelarabine.

This is our new normal.

But, with this, we have tremendous freedom.  Starting now, Gabriel is permitted to be a normal activity and is expected to be able to resume the activities he was involved in before his cancer diagnosis.  Monday, his birthday, Gabe will be going back to school.

Life will slowly begin returning to normal.

Once he’s done with all of this Nelarabine treatments, he has the choice to have his central line/Broviac removed.  Once the site is healed, Gabriel will again be able to take baths, go swimming, and be even more active.

Chet and I are currently in Utah for Chet’s 3rd 100 miler of the year – the Bear 100.  I’ll try to pose an update or two.  Gabe and Rebeka are holding down the fort with Chet’s mom and my mom.

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That Giant Sucking Sound . . .

You hear was the wind being suck out of our sails this week.  Gabe was scheduled to start maintenance Friday, yesterday.

No, he didn’t start maintenance yet.

Wednesday we spoke with Connie, the nurse practitioner who we deal with a lot at Children’s Hospital Oakland, and his counts had barely come up since Thursday last week. Gabe’s ANC has to be at least 750 in order for him to start maintenance.  As of Tuesday, he was a little over 300.  He was just very slowing coming up, and that meant there was no way we’d make it to maintenance as scheduled.

I was crushed.  I am so ready to make it to maintenance. It’s like this line in the sand that once we make it to there, we can begin to have a normal life. We will no longer be hostages.  Gabe will ultimately be able to go back to school.  We can go to stores as a family.  We can go to movies, eat out at restaurants – have a normal life.

Chet and I had started making plans for this weekend.  We were planning a nice weekend as a family, camping, going out for at least one or two celebratory meals. We were going to be like a NORMAL family.  Chet and I got our hopes up, even though we knew were shouldn’t.  We couldn’t help ourselves.

So, when Connie’s call came in, it sucked. My heart just felt so let down.  Not by anyone in particular, not by anything.  I was just so incredibly disappointed.

What’s silly is that it’s not like we are put off that long. We’re probably going to make it next week, but we’ll have to see.  What’s a week?  What’s two weeks?  Really, in the grand scheme of things, it’s nothing.  But, when you’re so tired of life being a constant unknown.  When every day presents a new uncertainty, the concept of maintenance is so alluring.  You just yearn to be there.

Admittedly, a lot of the “romance” of maintenance at this point is unrealistic for us.  We know that the first several months will be filled with a lot of tweaking to get the daily and weekly medications right so that Gabe’s counts stay stable.  We know that there’s going to be a lot of adjustment.  But, we’ll be in the coveted phase “MAINTENANCE.” That in itself will be huge.

So, tonight, we were supposed to be camping, Gabe, Rebeka, Chet and I.  We were supposed to have had fresh seafood.  We were supposed to have gone hiking.  We were supposed to have been celebrating.

Instead, we’re chilling as a family enjoying the bounty of our garden.  We’re harvesting, canning, and preserving. We’re following our advice “keep on keeping on.”

We’ll know next week where Gabe’s at and whether we’ll be able to start maintenance next week.

Most importantly, we know that God wants us right where we are at.  We’re content with that.  When it is time for Gabriel to make it to maintenance he will.  All along this journey, Gabe’s cancer treatment has been in His hands.  And so far, He’s been doing a pretty amazing job, so who are we to question where we are at.

On a side note – I mentioned today we’ve been harvesting.  This was one of our purple cauliflower’s that we grew.

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And The Wait Continues

We’re at the tail end of delayed intensification right now, and currently we’re just waiting for Gabe’s counts to come back up enough for him to begin the maintenance phase of his treatment.

These past several weeks have been stressful, incredibly stressful.  Knowing that Gabe’s immune system is completely in the tank brings back a lot of anxiety, fear, and neurosis.  Memories from the first time we went through all these drugs come back and haunt Chet and I.  The fear of another infection, another hospital stay, watching Gabe just be miserable.  We’ve been just waiting, holding our breath and waiting for this last nasty, horrible, awful, despicable phase of his treatment to be done.  And, we’re nearly there.

Chet and I are just starting to allowing ourselves to breath.  And I think for me, I’ve just kept my head down.  So, I’m sorry to all of you looking for updates…there hasn’t been a lot to report except our stress. Honestly, writing about stress and fear isn’t always the most appealing thing, particularly when there isn’t a whole lot of context to put it into or new information to share.

But, now that we are seeing the end of the intense phases of Gabe’s treatment, Chet and I are trying to get excited about the possibility of a fairly normal life, or at least as normal as it will be until April 27, 2014 – which will be the VERY LAST DAY Gabriel has to take any form of chemotherapy.

Once Gabe starts maintenance treatment then he’ll be released to start school again.  And that brings up a whole new round of excitement mixed with incredible amounts of anxiety and apprehension.

So, assuming all goes as planned, Gabe will be starting maintenance on Friday.  We’ll have a better idea tomorrow when we get the results from his blood draws from this morning. If you’ll keep us all in your thoughts and prayers, we’d greatly appreciate it.  We’re so close, and we’re just ready to be there, desperately ready to be there.

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