June 23, 2009

Stef sends an update with pictures

Stef sent out an email to the family over the weekend detailing her thoughts about the crazy week. Was it just last week? Seems like ages ago! Here's Stef's letter:

Hello to our dear family and friends,

As some of you know, we have had quite a week. If you don’t mind me taking up some of your time, I would like to share with you about our experience.

About 4 ½ weeks ago our little Jessie began to complain that her thigh was hurting. As a mom, I brushed it off as growing pains, and told her that it would go away soon. As the week went on, she was still complaining about it, and I noticed that she was hurting a lot when she ran and that she was favoring her other leg quite a bit. So at about day 3 I made an appointment to see the doctor, upon which we were not seen by her regular pediatrician. The NP did a brief check-up and stated nothing was wrong, as I had thought. While we were in there, we did see our doctor in passing, whereupon he asked what we were doing! We explained, and he told us to let him know how things were going in the upcoming week. Well, a week later, I still noticed that she was greatly favoring her other leg, and even though she was not complaining about it as much, I could see that she was still in pain. So I left a message for the doc, and he responded immediately. He saw her that day and ordered blood work and an x-ray. The results of both were normal, which was great, but didn’t really solve the problem.

The next week I called again and he referred us to an orthopedic. She reviewed the x-ray and called for another on her pelvis to see if perhaps the pain was caused by arthritis in the hip. Well…it was fine. So she ordered a complete body bone scan so that we could locate the “hot spot” – the exact place of anything abnormal. Well, this past Monday, 15 June 2009, I called to try to make an appointment for the bone scan, and we could either get her in that day or on Thursday. We scheduled it for that day and I found places for the other two kids to go. As the bone scan became more and more clear, we could see that sure enough, there was a very large “hot spot” on her right femur, exactly where she had been complaining of the pain. We also noticed that there was a slight “hot spot” on her left femur, her “good leg”, as well. I was trying really hard not to jump to conclusions! They ordered another x-ray immediately, and sure enough, on her right femur (the hurt one), there was a large abnormality. They forwarded those results to her orthopedic, and an emergency MRI was set up for the next day.

If any of you know anything about getting an MRI, you need to stay still for about 30-45 minutes. With young children they like to sedate them so they can get the best picture on the first try. Now, at The Children’s Hospital, an appointment for a sedated MRI is looking at about 6 weeks out. However, they scheduled her in on Tuesday at the end of the day. Needless to say, that was the longest day of our lives, going until the next morning. Wednesday morning the orthopedic phoned us by 8:am and told us that we would need to meet with the pediatric orthopedic oncologist that day. He has been taken out of surgery twice to review Jessie’s MRI results and he wanted to meet with us that day and set up a biopsy for the next day. As you could imagine, none of this was looking like a situation that any parent would want to be in. Dan and I were very emotionally drained. We had told the situation to our family, of course, and to many of our friends. We had so many people remembering Jessie and us in their prayers, and by this point, we could truly feel those prayers with us. Thank you.

So, Wednesday evening we met with the oncologist and he went over all of Jessie’s x-rays and MRI result with us. Interestingly, when we looked at her very first x-ray from 2 weeks ago, we could see a slight abnormality on it. It was very slight, however, so no one spotted it until we knew where to look. He spoke with us about the procedure and what he was looking for. He also ordered an second blood test, which again came out normal. He did tell us however, that the two things he was looking for were leukemia and a benign tumor called Langerhans Cell Histiocytosis (LCH). Well, it was a completely up or completely down result. We checked-in to the hospital the next day, Thursday 18 June 2009, at 7:am, to prepare for a 9:am biopsy. Jessie was so brave and did so well. Much better than her parents. J As you can imagine, the time did not fly. But the moment did come when the doctor and his team came out to meet us. He diagnosed Jessie with having LCH. I can cry tears of joy now. What a moment in your life.

The anticipation and anxiety of trying to prepare yourself for a turn that you have feared since the moment your child was born. Then to be given the blessing of an answered prayer when your told that this condition is generally treated with Tylenol or Advil. On rare occasions a child will take a MILD dose of chemotherapy, but only if the tumor is invasive to the bone or another organ. So for the next year Jessie will have a series of x-rays, and most likely she will have other bones that will be effected. We already know that there is one forming on the left leg. Today is Saturday. Jessie will get to take the bandage off tomorrow. We will begin to strengthen her little leg, and remember to thank our Heavenly Father everyday for the health of all of our children.



Just reading that makes me say 'Whew!!' What a blessing to have everyone home and on the mend! Jessie's uncle Evan (who is in the mission field) also sends his love and gratitude that Jessie is ok. He didn't hear about it until it was all over. :)

And now, pictures!!
Jessie after her surgery. OUch!!

Dad changes the bandage. Look at that little swollen leg!

That was some incision! Almost the whole length of her thigh!


That was exhausting!

Ellen's getting some Z's, too.













June 18, 2009

WHOOOOOP!!!

Just got the call and everything is benign! Jessie's doc says that the biopsy should stop the pain and she doesn't have to go back in again for 3 weeks. After that it's a checkup every 3 months.

Thanks to everyone who has offered prayers on her behalf and on behalf of the people who love her to pieces. It's such a relief and I'm SO glad that Dan and Stef get to take their little girl HOME today. YAY!!! It's cause for celebration!

:)

Great blood work and a biopsy.

Jessie is in for her biopsy right now. I understand that it's a bone marrow biopsy, just to rule out leukemia.

The best news is that her blood work came back completely normal yesterday! Thank goodness. Dan and Stef talked to an orthopedic oncologist who said that the only two possibilities were LCH and Leukemia. I haven't heard of LCH. He mentioned that it's pretty much the same thing as LCPD (my completely unmedical diagnosis from yesterday) but that they've changed the name. I'll be looking it up today and sharing more info soon.

It's been a wacky 3 days for Jessie. She's been under goofy gas twice and had blood drawn twice and now she'll have three little stitches as a result of the ENORMOUS NEEDLE they have to use for her biopsy. Not to mention the MRI, X-Rays and bone scan. Whew! And she's only 5! Danny says she's been a trouper (how do you spell that word?) and I believe it. She's always been sunshine trapped in a little skinny body.

More news as soon as I get it.

UPDATE: Click here for a not very thorough description of LCH. It is NOT the same thing as LCPD. At all. However, it is not cancer, either.

Langerhans cell histiocytosis (LCH) is a rare disorder that primarily affects children. The disease was first described in medical literature around the turn of the 20th century.

A histiocyte is a form of white blood cell. Its job is to help destroy certain foreign materials and fight infection. For unknown reasons, patients with this disease have too many histiocytes (Langerhans cells). These cells accumulate in different organs and can result in a variety of symptoms.



And then this:

The cause of LCH is unknown. It may be triggered by an unusual reaction of the immune system from something commonly found in the environment. It is not a known infection or cancer. It is not known to be hereditary or communicable.

Over the years, cancer treatments have been used in patients with histiocytosis. Consequently, hematologists and oncologists, who treat cancer, also treat children with Langerhans cell histiocytosis. However, the disease is not cancer. Radiation therapy, if used, is given in much lower doses than that which cancer patients receive.

The vast majority of patients will survive the disease. Some may develop life-long chronic problems, while others remain symptom free. In some cases the disease is fatal. Usually these are very young infants who have a rapid downhill course and do not respond to any known treatment. Whether or not the disease responds to treatment will often depend on the extent of organ involvement; however, it is often difficult to make definite predictions. Physicians will be able to discuss the patient's likelihood of responding to treatment and doing well.

It is estimated that 8.9 of every 1,000,000 children under the age of 15 have histiocytosisSeventy-six (76) percent of the cases occur before ten (10) years of age, but the disease is also seen in adults of all ages.



Here's an interesting blog about a little gal who had LCH lesions on her skull. She went through a little bit of chemo was right as rain after that. Emily was 4 when she was diagnosed.

June 17, 2009

Update today - LCPD

Danny called this morning to tell me about the MRI results from yesterday. They're not seeing a lump, per se, but they do see the bone trying to heal itself. There are definite calcium deposits and they're not sure what they are.

Possibilities they threw out there:



Background
Legg-Calvé-Perthes disease (LCPD) is the name given to idiopathic osteonecrosis of the capital femoral epiphysis of the femoral head. The goal of treatment is to avoid severe degenerative arthritis.

Pathophysiology
The capital femoral epiphysis always is involved. In 15-20% of patients with LCPD, involvement is bilateral.

Frequency
United States
One in 1200 children younger than 15 years is affected by LCPD.

Mortality/Morbidity
LCPD is a self-limited disease if not treated.
Outcome is extremely variable.

Race
Caucasians are affected more frequently than persons of other races.

Sex
Males are affected 4-5 times more often than females.

Age
LCPD most commonly is seen in persons aged 3-12 years, with a median age of 7 years.

Clinical History
Symptoms of Legg-Calv é -Perthes disease usually have been present for weeks because the child often does not complain.

- Hip or groin pain, which may be referred to the thigh
- Mild or intermittent pain in anterior thigh or knee
- Limp
- Usually no history of trauma

This sounds like a possibility to me, which I have to say is an EXTREMELY GOOD THOUGHT. If you click the 'treatment' link at the bottom of the page, it seems like the treatment is for pain only and she'll grow out of the actual disease.

*taps foot* I'm keeping my fingers crossed. She seems to fit right into the demographic.

She'll have more blood work done today and then a bone biopsy tomorrow. Poor little gal. We're all on pins and needles to find the real diagnosis.

June 16, 2009

Introducing...




Our girl, Jessie Kay. She's almost 6. Brilliant. Gorgeous. Hilarious. Perfect.
I'm Cecily, her aunt. I'm going to blog about my thoughts and highly biased medical research right here until we know her diagnosis. :) Please comment and forward to anyone who might be interested.






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