Last IV chemo

Yesterday was a special day!  Olivia had her last Vincristine (chemo through IV)! It's the best Christmas gift ever! All her blood counts are at its best too! Her ANC is 4,000+ and her HGB 10!

From now thru Jan. 9 she will continue to be on her oral chemo meds and then she will be completely done with treatment.

When we asked Olivia what her wish for Christmas is, she said she just wants her brother to be happy. Throughout the 2 year+ course of treatment, the 2 of them have been having a hard time dealing with the side effects of her meds (mostly the mood swings from her steroids - dexamethasone). Our 6 year old son has been looking forward for this day and if you ask him, Olivia being done with treatment is his only wish so that Olivia will always be happy. We feel so blessed with our kids!

Olivia has so many nicknames but we call her Liv/Livi most of the time. And now we realize how much her name fits her so well. She is so full of life. In her very young age, she is LIVing a life with so much love to give and thinks of others before herself. She is our miracle. Everyday is a blessing! 

Wishing everyone a Merry Christmas! Thank you for your continued support and prayers!

Last spinal tap; 2 years in remission

Olivia has been doing well for the past couple weeks. October through early November was really a rough month for us. 2 weeks ago, she developed a fever again and had to be brought to the ER (about 2 weeks after being discharged from her last stay). Luckily, her blood counts were good and she didn't have to be admitted. She was given antibiotics instead as a precaution. Her fever lasted only a couple days. It was a relief to know that her body was fighting an infection well. Her blood counts did not go down even with the infection. For the past few months, having a fever for her meant being admitted at the hospital for about a week and an automatic blood transfusion.

Today was a great day! Olivia's last spinal tap! I told her last night that it will be the last time she will have to be put to sleep for a procedure. She was so happy and excited! She even did the honor of pushing the syringe that put her to sleep.

I remember during Olivia's first 6 months of treatment I said to myself it was the worst 6 months of our lives. Looking back, everything we went through just made us stronger- as individuals and as a family. Though it was difficult to understand in the beginning, we soon realized that God had blessed us with a warrior. Despite what we went through, we knew we were given the gift of courage and faith that will remain in us forever. As we left her outpatient room, the nurses all gave her a big round of applause. Job well done, our sweet princess! You make us so proud! She would always tell us she never gives up. Even during her weakest moments, she showed so much courage. Sometimes it's hard to believe that she was only 2 1/2 years old when she was diagnosed. We walked away leaving so many memories, good and bad, in the pediatric sedation ward.

In a couple days, Olivia will be 2 years in remission. She still has 1 more round of Vincristine next month then it will just be oral chemo from then until January. After that, we'll be completely done with chemo! Thank you for your continued support and prayers! Before we know it, 3 more years will pass and we can finally say that she survived cancer.

Never Ever Give Up

Chemo day ; 2 years post diagnosis

Olivia had her Vincristine today and her blood counts today showed improved results. Her ANC started to go down a month ago at her last Vincristine chemo.  At that time, she was taking 100% dosage of her oral chemo. We now notice the pattern that when her dosage goes back to 100%, that's when her counts go down. When she has an episode of fever and neutropenia, her dosage is taken down by 50% of her usual dosage. However, she cannot start the oral chemo unless her ANC levels are at least 750. I have also noticed a pattern that it usually takes 2 weeks for Olivia to recover from neutropenia and get her counts back up. This month though, it took her 1 month to recover. She began this month with 844 ANC and it plummeted to 80 after a couple weeks. We had to pull her out of school again after 1 1/2 months of being back. Today, her ANC results were at 1700+! She is now back to taking  oral chemo (6MP and Methotrexate), but starting with 50% dosage again until her counts show consistent good results.

As Olivia was being examined by her oncologist, I mentioned to him that it was  exactly 2 years ago today when Olivia was diagnosed. It's hard not to recall all the things we have been through for 2 years. The doctor had a great point though. He wanted me to look the other direction - that in 3 month's time, Olivia will be done with treatment! It's definitely something we are all looking forward to!

Still Neutropenic

Olivia had her blood counts today and she is still neutropenic. We didn't get the exact ANC count but doctor was estimating it to be somewhere in the 100's. For the past 2 days, she has been having low grade fevers during early evening, but then goes away naturally. We took her to the ER again when her temperature reached 101. But once we got there, her temperature came down and normalized.  Since it was low grade fevers and knowing that she was just admitted recently, doctor adviced to just monitor at home. Her blood cultures were negative too which is good. She still has the cold though so that's probably why she's been getting the fever. Her hemoglobin dropped again to 8.6. When she was discharged last Sunday, it was at 10.5. Though it came down, it does not require blood transfusion. For now, we wait again until the blood counts next week.

I can't help but question why just now? She is almost done with treatment with less than 3 more months to go. For about 1 year she was so healthy and didn't require hospitalization or blood transfusion. The past 4 1/2 months feels like she is in active chemo again. Maybe her body is really taking the toll on all the chemo she's been taking for 2 years. At the end of the day, I am just thankful that she was so healthy for the past year. It could be worse. We still feel blessed. I know she is such a strong and brave girl. She is a fighter. I kindly ask for prayers that she recovers soon so she can be back on track with her protocol.

Home now

Olivia was sent home yesterday afternoon. Her ANC went from 200 the other day, to 230. It's still low, but at least it's trending up. She was so happy and excited to see her family!

No further tests were made from the bleeding that happened the other night. Her counts were good and the doctors can't find a reason why she would bleed that much.

Olivia will be on chemo hold until her counts go back up. She is scheduled to go back on friday for bloodcounts. The doctors changed one of her medication, bactrim, which is an oral prophylactic medication that protects her from getting pneumonia.  They changed it to a different medicine which is now an IV push every 3 weeks. They are thinking it's possible that bactrim is contributing to neutropenia and they would rather change it to something else so Olivia doesn't have to miss a lot of her chemo dose. From what I understand, the replacement medicine is slightly less effective than bactrim. But since we are at the final stretch, the doctors are probably weighing what's best for Olivia. With the 3 episodes of neutropenia in the past 4 1/2 months,  Olivia has missed a lot of doses of chemo.

Hospital day 4

Olivia has been fever free for a few days now. She is still coughing but other than that, she is active and playful. Her ANC continues to go up. It was 80 when she was admitted, went up to 136 and 200 yesterday.

Last night was one of the scariest night we've ever had. Olivia woke up at 4 am and asked to blow her nose. Before I even got the tissue,  she started crying. I turned around to see her drenched in blood. Her nose was bleeding profusely, her mouth overflowing with blood. It was pretty traumatic. She was not coughing nor blowing/picking her nose for it to cause the bleeding. The doctors and nurses came in to help right away. One of the resident doctors wanted to transfuse with platelets immediately but the oncologist wanted to have CBC done first. Interestingly, all blood counts came back good and were even better than the other day. They even did another test to see how long it woult take for her platelets to clot. I learned that even though platelets are normal, if it takes longer than normal for it to clot then there's a problem. That test came back good too. Platelets were normal and so they didn't have to transfuse. We were all just surprised why she would bleed so much if her platelets were good. It was a LOT of blood. The bleeding went on from both nose and mouth for about 20 mins non stop. I'm glad this happened here than at home or I wouldn't know what to do.

Yesterday we were told Olivia might be able to come home today if her ANC continues to go up. We are still waiting for today's results.

With what happened last night, I'm not sure if doctors would want to do tests and we would have to stay here longer. It is very dry here in the hospital which I think is the culprit for the nose bleed. But what still baffles me is why she would bleed so much.

Will post updates later.

Hospital again

Olivia was admitted again yesterday after spiking a fever of 101.9. I kind of saw it coming because she would ask for a lot of water at night and that's how she was the last time she needed to be hospitalized. She was also running low grade fevers the past couple days but because it was lower than 100.3, we just needed to monitor her from home.

Blood counts from yesterday was low and she needed blood transfusion. Her hemoglobin was 5.9 (Her normal is 10 to 11). The transfusion happened last night and today we've seen improvement in her hemoglobin. This morning her HGB is 8.6. Her ANC didn't really show improvement from yesterday. It's the lowest it has been at 80 ANC post diagnosis. The good thing is that she is 24 hours fever free. As usual, her ANC needs to go up before she can get home.

She is keeping herself busy with her new Cinderella outfit, thanks to Spirit Halloween for the event they had at the hospital! She is asking when she will come home and I always just explain to her what's going on like I'm talking to an adult. She gets it and I'm proud of her.

Low ANC

Olivia had her monthly Vincristine today. As she was getting examined by the doctor, we noticed she had some sores in her mouth. She has no fever though and she seems active and well the past few days. I also showed the doctor what I initially thought were bruising on her leg after getting mosquito bites. She had a few spots on her leg (4 big ones and a few small ones). It turns out it was discoloration in her skin which is a usual side effect from chemo. It takes longer time for chemo patients to heal from cuts, mosquito bites and could lead to skin discoloration. Nothing to worry about that. She is not bothered by it, nor the sores in her mouth.

We will need to monitor her closely however, because her ANC is only 884 which is low. We will have to keep her off school for at least a week. She was also scheduled for her dentist check up and flu shot this coming week, but because her counts are low, we will have to hold off for right now. I just realized she cannot get Flu shot anyway while on dexamethasone,  which she starts again today for the next 5 days. Her hemoglobin also dropped to 8.4 from about 11 if I remember correctly from last month. It is not that low that would require blood transfusion though.

She is scheduled to go back for blood counts 2 weeks from now. Praying for better results then.

Maintenance Cycle 6

Olivia had her 2nd to the last spinal tap procedure today as we entered Maintenance Cycle 6! It was exciting to discuss with the medical staff the remainder of the protocol schedule as we are almost at the end! Aside from her monthly vincristine and daily oral chemo until January,  she has 1 last spinal tap (1 last cycle) left on her protocol!  We are almost there!!!

Her blood counts have been good (ANC of 2,088!!) and so she is back to 100%-125% dosage of her chemo. Praying that there will be no more roadblocks as we approach the end of her treatment.

Other than that, Olivia has been doing well and very happy that she is back in school now. She missed all her friends and is very excited to make new friends everyday!

Chemo resumes

After 3 weeks on chemo break,  Olivia's blood counts finally normalized and is now back on her chemo regimen. Her ANC is now 1520! Yay!  But because she has had 2 episodes of fever& neutropenia,  the doctors had to take down the chemo dosage to about 60% of what she normally takes. Her blood counts will also be closely monitored. Until she goes back to 100% of the dosage,  she will have to get regular check ups and blood work every 2 weeks now instead of once a month. When her blood counts show consistent good results,  only then will she be back on her normal dosage.

I'm hoping she adjusts well with chemo after taking a short hiatus.

Neutropenic again

Olivia had her blood counts done yesterday,  1 week after being discharged from the hospital. She left the hospital last week with an ANC of 544 (normal is 1500). We were hoping that by this time her counts would go up to the thousands since the last episode, her counts went back up within a week. Surprisingly her counts went down again. Though her red blood counts are good, her ANC is now down to 288. She looks pretty healthy and active though so we don't want to worry too much. We are actually surprised that she has been eating well even without the appetite boost from her steroids.  She has been on chemo hold for 2 weeks now and because her counts are still low, chemo will continue to be on hold until we go back for another blood count next Friday. Sometimes I don't know how I feel about chemotherapy. It's good that it kills cancer cells but I don't like that it also damages the good cells causing her blood counts to go down. I worry that if she is not getting the dosage she needs as part of the protocol that there is higher risk for a relapse. At the same time I wouldn't want for her body to continue getting these toxic medication if it would mean her health is jeopardized.

Olivia's last fever/neutropenia episode made her stop chemo for 2 weeks. I remember that when she started chemo again, we noticed that her body had a difficult time adjusting to chemo again. Especially with the steroids where mood swings were really bad. This time we know for sure that her chemo is on hold for at least 3 weeks. I just hope her body would adjust fairly well once chemo resumes. Praying that her counts go back up to the thousands next week.

Home at last!

Olivia was finally able to come home on Friday night! Though an ANC of 544 is still considered neutropenic, she is on the right track and will only get better in a few days. She is scheduled for a follow up check up next Friday to see how her ANC levels are. Her oral chemo will continue to be on hold until we know the results of her blood counts next week.

Based on what we were told the last time Olivia was hospitalized,  it takes 2 episodes of fever/neutropenia before the doctors lower the dosage of chemo. We will know more next week if there will be a change in Olivia's protocol.

Day 6 at the Hospital

Olivia has been fever free for a few days now. Her red blood count went back up to 11, which is her normal count during the maintenance phase. The only thing that the doctors were waiting on before sending her home is that her ANC goes up. She is still coughing but it is slowly getting better. For the past couple days, her ANC has been going up and down, but still below 200. Today on her 6th day at the hospital, her ANC improved significantly at 544! I think she will be going home today! We are just waiting for her doctor's final decision.

I got the chance to visit her as soon as I got discharged from my hospital stay 2 days ago. So nice to spend even just a few minutes with her! She understands that I needed to come home with her baby sister. She is the sweetest!

I really hope she gets to go home today. Miss her so much!

Medical update

Olivia had a successful blood transfusion on Sunday night. It brought her red blood count to 10.5. Her ANC on Monday morning went up to 200. This morning, her ANC went down again to 125. Last fever was Monday afternoon so it's been 24 hours that she is fever free. She still cannot get discharged however because of her ANC levels. Her ANC needs to be at least 400-500, or at least trending to get close to that level. She is most likely fighting an upper respiratory infection. Her cough is still bad, but her lungs are clear. Her body just needs to fight this infection and recover on her own. Her chemo was held beginning Sunday and just like last month, she will have to continue holding off on chemo until her counts improve.

Other than that, she has been in good spirits and very motivated to get better so she can see her baby sister. She is so proud to be a big sister, telling everyone at the hospital about her baby sister. I haven't seen Olivia for 2 days now since giving birth. It's been tough not being there for her, but I know she's a fighter. Thanks to technology, we still get to see each other through face time.

I hope blood counts tomorrow morning will show improvement.

Olivia's reaction after seeing her baby sister

2nd episode - fever/neutropenia during maintenance

Olivia is back at the hospital on a Sunday early morning. She had a 101 fever and was coughing. She was also noticeably tired and pale the day before. It turns out her blood counts dropped, with an ANC of 100 (Normal is 1500). Her red blood count was also low at 6.8 and therefore needed blood transfusion. It was a very similar episode of last month when she was last hospitalized.  It wasn't that easy to get the transfusion this time because she was running a fever the whole day. She couldn't get the blood transfusion if she has a fever. It hasn't been 24 hours yet but so far her blood culture is still negative from a bacterial infection. Finally at around 10 pm on sunday night, her temperature normalized and was able to get blood transfusion.

It was a hectic day for all of us. All this happened the day before I was scheduled to give birth. It really was like being thrown a curve ball with little time to react to the turn of events. Luckily with family close by, we had put a plan in place. I know we've had worse days than this. This I know we can handle. I trust God he is with us during this trial.

Olivia didn't want to let me leave last night but I told her I had to go to my hospital to get her baby sister out. She smiled and got excited. Looking forward to better days ahead when we are all home.

1 year in Maintenance

This month marks Olivia's 1st year in Maintenance. She has been doing well overall. I get questions once in a while asking if Olivia still has leukemia or is she completely healed. She is currently in remission and is in the final stages of her treatment. 6 more months to go and she's done with chemotherapy! The chemo during maintenance phase is like finishing antibiotics. You need to make sure you take it through the required duration to make sure the leukemia cells doesn't come back, and to make sure it continues to kill leukemia cells that might be hiding. When Olivia was considered in remission, there's this "minimal residual disease" that doctors measure. So it is still possible that there are some "monsters" still hiding and that's why we have to continue chemo for this long. Once she reaches 5 years in remission, we can finally say that she survived cancer!

I can't help but get sentimental at times especially when we found ourselves in the same restaurant (and the same table) where we were at exactly a year ago. Last year we celebrated Olivia's last chemo before maintenance phase. And look at her now. She has grown a lot, grown her hair and is the sweetest now more than ever! We celebrate her life every day!

1 year ago - last day of chemo before maintenance

Olivia 1 year later

Maintenance cycle 5

Olivia had her blood work done last Thursday and we're happy to report that her counts have improved a lot from last week. Her ANC is now back to 1100. Still below normal, but a big jump from falling below 200 last week!

She had her scheduled spinal tap yesterday,  Friday and all her chemo regimen is now back to normal. It was a good week off chemo, for both my husband who administers the meds and specially for Olivia. No fasting for a week (she fasts daily for her meds) made it easy for all of us.

As I was talking to her doctor after the spinal tap procedure, she was surprised to know that last week was just Olivia's first episode of fever & neutropenia since maintenance started and we are already in cycle 5. I guess that's a good thing. It's sad to know that it happens more often to  other kids. I think about all the other kids always and I know each and everyone of them are a fighter in their own ways. We'll get through this!!!

Olivia is getting into the habit of helping the doctors with the injections and this time, she helped out injecting her anesthesia. She had no idea what she was taking in although she was saying she is going to outerspace! She was really hungry before the procedure but couldn't eat anything until after spinal tap was done. When she woke up, she was happy to have her favorite froot loops!

Home at last

Olivia was able to get discharged today at around 8pm. Her blood counts are still low,  no improvement from yesterday. But because she had no more fever,  the doctors let her go home so she can attend her uncle's wedding. It made her so happy! Not once did she complain when I told her we have to stay at the hospital for a few days. She understands. When she was told she can go home,  she cried happy tears. As soon as she got home she asked to practice her flower girl walk!

We just need to be very careful because she's prone to infections due to low ANC. She'll be wearing her mask and will be taking a lot of rest during the wedding. The doctor said if she develops a fever,  we will need to bring her back to the hospital right away. Her infection was most likely viral because the blood culture was negative from bacterial infection. 

We also asked the doctor about Olivia's hair loss because she lost so much hair the past few days. She said even at maintenance phase,  she will still lose hair but she won't get bald.

All chemo is still on hold. Olivia is scheduled to come back on friday next week for blood counts to see if she is ready for chemo again.

After bedtime prayer tonight,  Olivia said she was so happy to be home. God is good all the time!

Day 3 at the Hospital

Today is Olivia's 3rd day at the hospital. Yesterday she was so much better, more color (thanks to the transfusion!), and had a lot more appetite. She had no fever overnight too. Her hemoglobin count is now 9 and white blood count is 1. The problem still is her ANC. It is only 100 (normal is 1500) and is severely neutropenic. This is most likely caused by an infection. It takes a couple days for blood culture results to come back to find out if it is bacterial infection. She started antibiotics as soon as she got admitted though in case it is really a bacteria that is causing the fever.

The doctor will let me know today if he can send Olivia home today and if she could attend the wedding tomorrow. There's nothing they can do to increase her ANC. Her body just needs to recover on its own and it could take until next week before her counts go up.

More updates later today once I speak to the doctor again.

1st hospitalization since last year

Olivia is admitted to the hospital today after about a year. She developed a fever a few days after her mouth sores appeared. She has been running low grade fever for 4 days and started coughing now as well. We have been in contact with her doctor since the weekend and we were just monitoring her from home until today when the doctor adviced to come to the hospital and get checked. Doctor was worried as she was showing signs of dehydration already.

The doctor saw her sores are getting better and had started her IV fluids for hydration.  At first we, the doctor, nurse and I thought it will just be a quick visit for hydration and we'll be able to go home after an hour since there were no signs that she needs to be admitted.  We still had to wait for blood test results though.

Good thing Olivia got tired and sleepy so she just slept for an hour while waiting for fluids to be done. She woke up for a second just to say "mama, I love you!". This girl knows how to make mama feel better. I was so anxious waiting for blood tests to come back. For some reason I had a feeling something is not right..even when the doctor was initially thinking of sending her home after fluids.

Blood tests came back and doctor was surprised with the results as well. Her hemoglobin was 5.6 (she has been at 10+ for about a year now) and will be needing blood transfusion tonight. White blood count was 0.7 (she has been somewhere around 3+ for about a year). We didn't get her ANC count yet, but with a WBC of 0.7, that definitely means her ANC is low and is neutropenic. All chemo will be immediately stopped for now due to low counts.

Traumatizing events came back to my mind. It brought me back to diagnosis day because her counts haven't been this low since diagnosis. So I asked right away if there is a concern that she will relapse (cancer coming back). I was told that infection in her body can cause her counts to go down. And that since she is standard risk, I shouldn't think of relapse right away. I just find it so strange because her counts have never been this low since diagnosis. I'm praying that everything will be ok and that this too shall pass. It's true what they say though about mother's instincts. Something about the consistent low grade fever tells me there was something wrong. But we're here now and Olivia is trying to get better.

Other than blood transfusion tonight, we are also waiting for blood culture results to see if she has any bacterial infection that is causing the fever. As for Olivia's condition, she is usually tired and sleepy. It's also so weird to see a lot of hair falling again too. She hasn't been eating well but I've been telling her about being a flower girl for the wedding this weekend and that motivates her. I really do hope she can make it to her uncle's wedding as this is the first time she'll be a flower girl. She has been looking forward to it for the longest time!

Dealing with mouth sores

Olivia developed some mouth sores recently which is a common side effect from her chemo meds. She has some on her lips and a lot on her tongue. The ones on her lips bled a bit yesterday and now the sores on her tongue is causing her pain and discomfort when eating.Trying to feed her soft food while her mouth sores are still not healed. She loves eating pretzels though, but it will hurt her more if she eats hard food. Hopefully it heals soon.

Birthday chemo

Yesterday was chemo day and Olivia was surprised with toys! Just like last year, she was able to spend her birthday with her nurse friends. As always,  she was so brave the whole time getting chemo. No crying at all!

Her blood counts were good,  although her ANC is slightly below normal.  (1100 vs 1500 normal count). I was told not to worry too much about it and to let her enjoy her birthday weekend.

Olivia is almost a year and a half in remission. In about 9 more months, she is done with treatment!  I can't believe how much time has passed by already. Last year we had a small celebration for her birthday since she was still undergoing intense chemo treatments. This year, we planned for a big party for her and she is so excited! She deserves nothing but the best!

Chemo day

Yesterday was chemo day. It was a quick and easy visit to the hospital.  So proud of our brave girl!

She even has her own job at the end!

https://youtu.be/WUkSOd7wkgc

After chemo glow

Every time Olivia gets chemo,  I notice she has this certain look- she looks very tired,  droopy and dark under eye circles, and physically tired as well. I remember back in the intense phase of her treatment (delayed intensification), it was hard to recognize her as she would look really different after chemo. You know her body is taking a toll from all the toxic medication. You can't help but cry because you feel helpless. These are things of the past that makes us appreciate and feel blessed to be where we are now.

A few days after her monthly chemo,  and with the help of the steroids to increase her appetite, you will notice a certain glow, I call the after chemo glow. I took her out to breakfast and she told me it's the best day ever! I'm so happy to see her with so much joy and how she appreciates the most simple things.

Olivia 2 days after Chemo (Maintenance cycle 4)

Olivia 1 week after chemo

Maintenance cycle 4

Last Friday Olivia began cycle 4 of maintenance. She had chemo and spinal tap. And as always, she was so brave all throughout. She was tired before we got to the hospital and so she was sleeping for the most part while waiting for her procedure to be done. I got a bit worried because she had increased heart rate while the spinal tap was happening. She was breathing heavily even with oxygen support (she was sedated the whole time). Olivia looked flushed so her temperature was checked which could be a reason for the increased heart rate. Her temperature was good though and the nurse kept on monitoring her until she woke up.

That afternoon, the doctor gave us good news that her blood tests show that her liver function count has improved! A few minutes later the doctor emailed and asked for a number she could reach us at. Then we got nervous. We never got that kind of email before. She did say it was nothing urgent to worry about. But of course we still couldn't stop worrying. We found out that her glucose levels were low (glucose count 27). Doctor said there's different reasons why her glucose will be low. But as long as Olivia looked and acted fine, there's nothing to worry about. Chances are she was on fasting for a longer period of time than usual that's why her glucose was low. She needs to fast everytime she has a spinal tap procedure. There was a delay at the hospital that's why her procedure was done later than usual. I read about low glucose online and Olivia showed no symptoms that we should worry about.

A lot of worrying today but I'm glad everything is fine. Olivia's back on steroids and her appetite is fast increasing again! Only kids on steroids get a pass to eat chocolates for breakfast!

Update on liver function

We went for Olivia's scheduled check up on Thursday. I expected to have blood work to be done,  but after being examined by the doctor,  he said there's no need to. They would rather do it in 2 weeks when she is scheduled to come back for her spinal tap procedure. One less traumatizing needle poking for Olivia.

She was back to her cheerful self, no enlargement in the belly area,  no complaints of pain which made the doctor decide to not check blood count this week. He did say that her liver enzymes has been fluctuating. Many years ago,  this level of increase would be a reason to stop chemo for a certain time but recent studies show that they don't need to. I asked if there is a long term effect to her liver and the answer is no. He said the liver is one of the greatest organs in our body because it can recover on its own. I still pray though that her liver enzymes don't go higher than it did.

Quick check up

Today we took Olivia back to the doctor as she hasn't been feeling well. It's been 5 days since her last IV chemo and we noticed her unusual weakness for 3 days now. She is usually not this tired after chemo since she started maintenance phase. She also has not been eating well even with dexamethasone which always increases her appetite. She would tell us that she is so tired and requests to get carried. She has a slight cold but no fever. What we find odd is that she has had a cold before but wouldn't be as weak as she is now.

The doctor says she is definitely fighting an infection that's why she is so weak. She also developed some mouth sores, which is common for chemo patients, that's why she hasn't been eating well. Put those 2 things together, we have an unhappy camper. The good thing is she has no fever so at least her body is working hard to fight the infection.

We were also told that an infection can cause an increase in the liver function number (ALT). We still have to come back to the hospital next week for the scheduled blood work to find out the main cause of the elevated count. Basically right now her liver is working more than it normally should (5x more than normal). Doctor advised not to worry too much about it for now. It gets dangerous when it reaches 20x her normal count. And that's why it's good to monitor these levels regularly.

We ask for your prayers once again that everything with her liver will be ok. Thank you very much!

Monitoring liver function

Yesterday was chemo day and Olivia decided to come in her doctor gear. The night before, she was playing doctor with me and I was acting scared of the injections. She told me to be brave just like her! She could be a great doctor one day!

All her blood workfrom yesterday were normal except for a 5x increase in her liver function number (ALT count). Doctor is suspecting it might be due to her increased dosage of one of her chemo (methotrexate). She started to increase dosage probably 2-3 months ago and it was based on her weight. We will have to come back in 2 weeks for more blood work to monitor her liver function. For now, we were advised to keep the dosage the same at home.

Hoping and praying everything will be ok.

Snow play

Olivia had so much fun playing in the snow! I realize, this was her first time ever playing in snow because before she got sick, she was too young then to appreciate the snow. Last year at this time, she was mostly tired and not up for any snow play at all. This year was great for her and even for just a little bit, she had so much fun outside! She played in the snow for about 10 minutes until she got tired. She just had her IV chemo 3 days before the snow day and the meds were probably still affecting her. As soon as she got inside the house, she fell asleep for a few hours. She was really tired, but it was worth it seeing her so happy!