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WHAT'S HAPPENING Archive June 2003

June 27, 2003 "Going With the Flow"

Simon's platelet count is 25 today. That's after Wednesday's transfusion. We'll hang out for the weekend and have him checked again on Monday. We still do not have an explanation for the drop. Simon's bone marrow aspirates, collected on June 19, are still not resulted. Apparently the lab is way backed up.

Markus and the kids are enjoying some sightseeing in the blistering heat of New York: Statue of Liberty on Thursday, possibly the Empire State Building today.

Mary is in Chicago, soaking up information from specialists who study and treat neuroblastoma, in addition to the many other families here. And for free time fun, she is scouting out furniture for our new house! If you're not familiar with it, take a look at Room & Board.

June 25, 2003 "More Information to Go On"

We now have most of the results of Simon's tests from last week. The upshot is that Simon will stay with the 3F8 antibody therapy and wait 3-4 weeks to see if his HAMA response subsides. If he becomes HAMA-negative, he can have the next 2-week course.

This is good news! It means that we have evidence that the antibody was effective on his remaining cancer. His MIBG scan showed slight improvement in the known bone/bone marrow sites and no new sites of cancer involvement. The bone marrow biopsy was clean! "No evidence of neuroblastoma." The bone marrow aspirate is still pending. Apparently the lab that processes these tests is pretty backed up at the moment, making the results slow to come.

Simon's platelets remain extremely low. His count dropped to 10 today, so he is receiving a transfusion. Otherwise, his counts are quite strong.

For the next 3-4 weeks, we'll be watching his counts carefully to be sure we catch it if he needs another platelet transfusion. We'll draw a tube of blood for a HAMA re-test in early-mid July. And otherwise, we'll hang out and enjoy a little time off.

In a more efficient world, Simon would be heading right back into 3F8 antibody therapy to keep hammering at his cancer. In Simon's real world, he needs to take some time to absorb the hit from this therapy. Although it is not common, some kids do experience a platelet drop with anitbodies.

June 24, 2003 "Nothing New"

Thanks for checking in, but we don't know anything more today. Simon's platelets are down to 15, but Dr. Kushner decided not to transfuse. We'll check again tomorrow.

Test results are still pending.

Markus and Miriam arrived this afternoon, and we are all really happy to see each other.

June 24, 2003 "More Limbo"

We don't know much, but I imagine folks are eager to hear the latest. Here's what's going on.

  • We still await test results, without which medical decisions cannot be made. Simon's MIBG scan seems to indicate a decrease in disease. That's good news! His bone marrow test results are pending.
  • Simon's platelet count was 23 on Monday, and he's still bruising, although the slight nose-bleeds he experienced late last week have subsided. We'll check him again today to see if he needs a transfusion.
  • To make "waiting and seeing" easier all around, we've decided to stay in New York until we know our next steps. That means we can get test results and make decisions at a slow and careful pace. Markus and Miriam are joining us this afternoon. Simon and I are both really excited about that! And the rain finally stopped, so we can enjoy the City in the (hot) sun.
  • Mary will be heading to the Neuroblastoma family conference in Chicago on Thursday solo. Markus and the kids will hang out in New York. These various opportunities to stay in fascinating cities while our own household goods are in transit from Michigan to Utah is quite the deal, really. Markus managed to send the movers on their way yesterday, with copious amounts of stuff, including many boxes of unpurged stuff for me to sort in the new basement, someday!
  • Simon and Mary had a ton of fun with Devon, our companion for 5 days here. Despite the rain (and I mean RAIN), we got to hot spots over the weekend including the Metropolitan Museum of Art, the Guggenheim (well, the gift shop there), and the New York Hall of Science. The Lion King was sold out, so we'll keep trying. Mostly, we slept in, kept Simon up way too late, and enjoyed our light-ish hospital schedule.
  • We will continue to update this site as we have information and time to do it. Believe me, I know the waiting is excruciating.

    June 20, 2003 "A Steady State of Change"

    Simon and Mary are back in New York at Memorial Sloan Kettering Cancer Center and the Ronald McDonald House. There have been a few twists and turns this week. At this point, we have more questions than answers.

    Here's what we know:

  • Simon is HAMA-positive (he developed an immune response to the mouse antibody therapy after one cycle). Simon's doctor is "not surprised". Simon can't repeat the antibody therapy until the HAMA response is gone. He will be retested in about 3 weeks. If he's negative again, he can proceed to cycle two.
  • Simon can't have chemo any time soon for at least two reasons. He's had a big drop in platelets and has needed two transfusions this week (one on Monday in Ann Arbor and one today in New York). The other reason is that doing chemo would make him inelligible to continue the 3F8 antibody protocol.
  • Accutane is an option to tide Simon over until he's ready for the next antibody therapy. Also called cis-retinoic acid, this is an acne drug that has been used successfully against neuroblastoma (especially for patients with minimal or no active disease). Simon has not used accutane yet.
  • Here's what we don't know:

  • Simon had bone marrow aspirates and biopsies yesterday and an MIBG scan today. Results won't be available until early next week. So far, there have been no alerts of new findings from the radiologist (the nurse practitioner who conveyed this information said it's a bad sign when they do hear, which they haven't). We'll be waiting out a whole weekend, wondering.
  • We don't know when we're returning to Ann Arbor (maybe Tuesday?).
  • We don't know why Simon's platelets are taking such a hit, although other families have observed various blood count drops following antibody therapy.
  • People tend to wonder if developing the HAMA response is a good or bad thing. In Simon's case, it's a set-back because it's keeping him from continuing therapy for the time being. However, we won't know until Monday whether he has responded to the antibody therapy (i.e., if his marrow looks clear(er) and his MIBG scan shows less disease). If things are looking worse in any way (more disease in marrow and/or MIBG scan), then we will be looking at other approaches and discontinuing antibody therapy.

    So, gee, have a nice weekend! We're going to try to. We're hoping to get tickets to The Lion King. We had a big outing yesterday that included the Pokemon Store in Rockerfeller Plaza and the Toys R Us at Times Square. We are enjoying immensely the company and helpfulness of our travel companion, Devon (yet another member of Mary's staff at Arts at Michigan who has offered her time to accompany us to New York).

    June 12, 2003 "Back in Ann Arbor; A Great Deal Going On"

    Simon, Mary and Ann/Grann returned to Ann Arbor from New York on Saturday, June 7. Simon weathered the second week of antibody therapy much as the first. It is a tough and relentless process, but the relative shortness of the terrible parts somehow makes it bearable.

    Simon returns to New York on June 18 for scans and bone marrow tests. These tests will show how the antibodies have affected Simon's cancer. I believe you already know exactly what to hope for: lots of clean bone marrow and fading signals from metastatic bone lesions that were still lighting up on the MIBG scan in May. In other words, cancer going bye-bye.

    We have FedExed a tube of blood to New York to be tested for HAMA (human antimouse antibody). If Simon is negative for HAMA, he can continue to receive the therapy. If he's positive, we'll have to discuss next steps with the doctors in New York. Once the immune system has developed this response to the mouse antibodies, the therapy can no longer be used effectively. Patients in this situation can wait until the HAMA goes away, or they can pursue alternative therapies.

    In addition to this busy schedule with therapy in New York, we have an outrageous list of other family stuff going on. Most of it is exciting stuff, but the intensity is very high.

    For some of you, the news that we are moving to Salt Lake City, Utah may be a surprise. We have slowly worked toward this plan since the time of Simon's diagnosis. Markus accepted an appointment as assistant professor at the University of Utah Business School way back in March of 2002. In order to give us stability in Ann Arbor for Simon's treatment, he deferred the appointment and has been on leave status for a year. His official start date there is July 1.

    So, here's a quick list of what else is going on:

  • Markus defended his dissertation on June 6. His co-chairs signed off on it yesterday. And now he's tweaking the final wording of his acknowledgments before taking the 250-page tome in to the bindary. Yay, Markus!
  • Mary is wrapping up her term as director of Arts at Michigan, the office she has developed at the University of Michigan over the past 7 years. She will say farewell to colleagues and friends at a reception on June 13 at the Museum of Art. The Museum has been a special place to Mary in her work at UM, and it's a real honor to have a send-off there. In Utah, her new jobs will include: stay-at-home mom, stay-at-home Mary, cancer mom, faculty wife, singer(?), yoga practitioner, cook...
  • Our belongings are leaving for Utah around June 23, after a week of packing that Markus is planning to manage on his own. (Mary will be in New York...)
  • Markus and Miriam plan a trip to Salt Lake City to unload in our NEW HOUSE near the beginning of July. We bought the house in early May and can't begin to tell you how glad we are to make the change from our very family-friendly, but very cramped, location of Family Housing at UM.
  • We're planning to enjoy a week's repose in the lovely Crystal Lake/Frankfort area of Michigan with Mary's extended family as a last hurrah before all four of us head out to Utah.
  • Assuming the antibody therapy continues to be a "go", Simon will be returning to New York around July 16 for cycle 3 of tests and therapy. From Utah.
  • Isn't that ENOUGH?
  • June 1, 2003 "Update from New York"

    Simon has now made it through his first week of antibody therapy in New York. Go, Simon!

    All four of us arrived on Sunday, May 25 to take up residency again at Ronald McDonald House. It was fun to have Miriam along. She was very excited about being in the big city! Markus had initial hopes of catching a show on broadway (on his own and with the kids). The closest we got to a cultural event was to see "Finding Nemo" on its opening day last Friday.

    Keeping up with Simon's treatment schedule and dodging the rain have limited our activities somewhat. We spent a rainy Memorial Day close to the RMH, taking a break in the downpour to walk south to FAO Schwarz. Miriam got a baby doll in a front carrier (sort of like a Baby Bjorn), and she proceeded to take excellent care of the baby all week as we were in and out of the hospital. Simon was able to exchange a transformer that he'd gotten in duplicate for his birthday and get another one, his highly coveted "Optimus Prime" instead!

    Here's how the treatment went, starting on Tuesday morning.

    Simon arrives around 8:00 am. He gets weighed, temperature checked, and an armband to identify him. Then he hangs out until he gets called back to the outpatient bed area to take his beta-glucan. His dose of beta-glucan (a reputedly bitter concoction) is 21 ML (mililiters) or about 4 teaspoons. It's dosed in a syringe. He's not allowed to chase it with water. He is allowed to lick a lollipop before taking the medicine and then continue to lick the lollipop afterward. Aside from that, he has to avoid food and water for the next hour. He says the beta-glucan is very yucky. But, with the lollipop hooked up in a Zerg (from Toy Story) "spin pop" device, he's able to manage OK. Sour lollipops seem to work the best.

    After the hour of waiting, the infusion of the antibodies begins. That's when Simon has to stay in his bed. Before that, he's free to go to the playroom instead. In the room (which is a double, partitioned by dark curtains), he has a squeaky-hinged over-the-bed television, and he likes to watch Cartoon Network. He gets hooked up to IV fluids, and then they start the pre-meds: benedryl (to help with allergic reactions like hives to the antibody) and dilaudid (a cousin of morphine for pain).

    The antibodies are infused next. Initially, he doesn't feel anything. By the time the full dose is flushed through his line, the pain begins. Simon and the other children cry out in pain when their moment arrives. You can hear the others in the neighboring rooms. The saving grace is that the pain lasts less than 20 minutes. Simon manages his pain with hot compresses (on his abdomen and sometimes lower back), additional doses of dilaudid (at 10-minute intervals), listening to his Gemini lullaby CD,* relaxing back into a supported crosslegged half-sit against the raised bed, and receiving touch therapy from mom/dad to his forehead and abdomen. It's a pretty delicate balance. He requests more pain medicine and more "no-itch medicine". He's had pretty bad hives, especially on his face, for several hours following each day's infusion. When the pain subsides and the dilaudid/benedryl have taken hold, Simon dozes off for quite a while.

    Eventually, perhaps 90 minutes to 2 hours after the infusion, Simon is ready to head home. He's hair (what's left of it--he's got about 20% cover of 1" long hair since his last chemo) is matted from sweat. His face is slightly swollen from the allergic reaction. He looks pretty tired, and he feels pretty cranky. As we like to say, he can go from zero to sixty in about 2 seconds. By evening, though, he's usually back to normal and feeling pretty even-tempered and chipper. Amazingly, he never balks at going back for the next day. He is convinced that he needs this therapy to get rid of his cancer.

    We will head back to Ann Arbor on June 7. Miriam and Markus returned yesterday. Ann/Grann arrived in New York yesterday evening to take over on being the second grown-up. We enjoyed a Saturday evening dinner provided by the RMH and its team of Saturday volunteers. After dinner, the kids played mini-golf. Simon had some good beginner's luck and held the lead for a while. By the end of the game he was tied for third place. He was thrilled!

    We have taken in a few of New York's pleasures. Mary had breakfast with other cancer moms at the Central Park Boat House on Saturday. Markus took the kids to the Central Park Zoo. Today, Simon, Grann and Mary went to the fabulous American Museum of Natural History.

    We had our second visit from an Arts at Michigan friend today. Michael Steelman, a full-time employee in Mary's office, is in town for his brother's graduation from law school. He stopped by late this afternoon and spent some time with Simon down in the playroom at RMH. They played a bunch of the free arcade and video games together. Michael also brought a new batch of sour lollipops for Simon (he happened to be at Dylan's Candy Bar yesterday for his sister-in-law-to-be's bridal shower, and Mary asked him to get a little supply for Simon for week number 2 of antibody therapy).

    If you're in the City, do let us know!

    *We had actually forgotten to bring our Gemini lullaby CD with us. When Simon missed it, Mary fired an email request to San and Laz. The next day, a new CD arrived for Simon via FedEx from the eminently kind Laz. Thank you so much! The music really helps Simon deal with his therapy.


    Back to WHAT'S HAPPENING main page.

    Simon's story, and that of our family as we live on without him, appears on this Web site in reverse chronological order. Anyone who wants to see the whole story can scroll down to the bottom of this archive and start there. We have listed the treatments that Simon underwent in the short summaries for each archive link in case other families facing neuroblastoma want to take a look at Simon's experience as a point of reference.

      In 2006, entries on this page became sporadic. We named a ski run "Simon's Way". Miriam went to first grade. In December, she reached the point of being older than Simon was when he died.

      The second half of 2005 has come and gone. We hit the one year point since Simon's death on August 6th. We celebrated Simon's memory with a concert by the terrific group Two of a Kind at Utah's Hogle Zoo. Miriam has started kindergarten, Markus continues to work hard as an assistant professor, and Mary is doing a little teaching (voice and German) and pursuing her interest in writing.
      July-December 2005

      Miriam finishes preschool. We celebrate Simon's birthday on May 17, 2005 with an outpouring of community love and support during a Lemonade Stand in Simon's memory. We travel to Oberlin for Mary's 20th college reunion and on to Ann Arbor to hold a second memorial service for Simon on June 3rd. Mary attends a writers' workshop in Salt Lake City.
      May-June 2005

      Acts of mourning continue as life also moves forward. Mary travels to Denver and meets the bereaved family of Becca Lockler.
      April 2005

      The pace slows. We reach six months since Simon died, then seven. Mary and Miriam travel to Ann Arbor for the first time since Simon died.
      February and March 2005

      Working through grief; working on life; trying a few new things.
      January 2005

      Approaching "the holidays" without Simon and marking time with the moon.
      December 2004

      Our fourth month without our dear Simon included a busy and rewarding celebration of Simon's legacy with the music duo, Gemini.
      November 2004

      Life without Simon crawls along. Memorial tributes of all kinds are underway, from Simon's Memorial Fund to friends and family holding events in Simon's honor.
      October 2004

      Life without Simon creeps along.
      September 2004

      Simon died on Friday, August 6. We held his memorial service on August 28, and we established the Simon Craig Vodosek Memorial Fund to honor his beautiful spirit.
      August 2004

      The month began with Simon's wonderful Celebration of Life Party. As his disease progressed, he slowed down more and more, but he hung in there for the whole month.
      July 2004

      A wonderful end of Simon's first-grade year (June 4) leads quickly into a rapid progression of disease with increasing pain and weakness. Our focus is on pain control and other comfort measures to allow Simon to enjoy his remaining time.
      June 2004

      Recovery from radiation side effects and enjoying good energy to get back to school. Second course of temazolomide/irinotecan. Simon turned 7 on May 17!
      May 2004

      CEP-701 trial abandoned after 4 weeks because of further progression; begin palliative treatments to ease symptoms of jaw tumor and general disease, including radiation and chemo with temazolomide/irinotecan.
      April 2004

      Chemo abandoned after further progression; begin CEP-701 phase I clinical trial at UCSF
      March 2004

      More chemo (round 2 topotecan/cytoxan)
      February 2004

      Disease progression (widespread in skeleton) discovered during work-up at Memorial Sloan Kettering Cancer Center; begin salvage chemo with topotecan/cytoxan
      January 2004

      Begin accutane (vitamin A derrivative to fight neuroblastoma); consultation with Dr. Kate Matthay at UCSF
      December 2003

      ITP (immune-mediated thrombocytopenia purpura) continues; limited ability to treat cancer
      November 2003
      October 2003

      Irinotecan/vincristine at home
      September 2003

      ITP chaos
      August 2003

      Onset of ITP (immune-mediated thrombocytopenia purpura) AND move to Salt Lake City
      July 2003

      3F8 monoclonal antibody therapy at Memorial Sloan Kettering in New York
      June 2003
      May 2003

      Exploring monoclonal antibody therapy; prepared with topotecan/cytoxan
      April 2003

      Irinotecan/vincristine in the treat then evaluate mode
      March 2003
      February 2003

      Still recovering from MIBG therapy
      January 2003

      Finally starting kindergarten!
      December 2002

      MIBG therapy
      November 2002

      Recovering from transplant
      October 2002

      Stem cell transplant
      September 2002
      August 2002

      July 2002

      Several months of topotecan/cytoxan in the treat, scan, evaluate mode
      June 2002
      May 2002
      April 2002

      Mixed response to therapy--taken off COG A3973 after 4 chemo cycles
      March 2002

      Stem cell harvest (to be purged)
      February 2002

      Diagnosis and starting treatment
      December 2001/January 2002

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