Quote of the day (Thanks Charlie!):
"Any mother could perform the jobs of several air-traffic controllers with ease." ~ Lisa Alther
My friend Charlie sent me this quote today. At first I laughed, because I think being an air traffic controller has got to be one of the most stressful and grueling jobs I can think of. But upon further reflection, I have to say the role of a mom, is also a tough job, but the difference between the air traffic controller and a mom is a mom has signed up for the job 24/7. Factor cancer in this equation and there are just no breaks! Even before Mattie got sick, I always said parenting is the toughest and most humbling job around.
We had a slow day here. Mattie decided to open more of the gifts that he received and that we store in the "Mattie Pile." The Mattie Pile comes in handy various times during a given week! Thank you Dawnee (a friend and former assistant director of RCC) for the mini-helicopter. Mattie loves it, it is just his size. We also want to thank Michelle H. (a friend and fellow board member of GW's Columbian Women Association) for the great DVDs. Mattie doesn't have either "Charlie and the Chocolate Factory" or "Chicken Run." He is excited to watch these. It was like Christmas all over again for Mattie today! He then moved to a bunch of presents our good family friend, Lorraine sent him. Mattie loves the slinky and was very excited to see it go down our stairs. Mattie was particularly interested in the wood model kits and the giant search and find book. Thanks Lorraine this will keep us very busy! Mattie's last present that he opened was from Dan Page (who works with Peter's mom at The Fessenden School). Dan sent Mattie a Star War's lego set. Mattie immediately sat down with Peter and began to put it together. It took them about two hours. But you can see the finished product and the smile on Mattie's face.
Mattie realizes Peter is going back to work tomorrow, so he is enjoying the time he has with him today. He tackled Peter to the floor and then hopped on top of him. I thought it was very cute, so of course I took a picture of their moment together.
Mattie spent a lot of time playing with his air craft
carrier this morning and Peter and Mattie built a dock for this carrier a day or so ago. However, Mattie keeps refining the dock, and its pyramid shape!
We want to thank the Bentsen family for delivering us a wonderful tex-mex lunch of tamales, chili, salad, and other treats. Mattie loved the "magician" Christmas ornament and he loved the rabbit coming out of the magician's hat! Thanks for the wonderful ice cream too!
Later this afternoon, Mattie wanted to go back to Huntley Meadows and walk or I should say stroll through the woods. So we headed back there and got some fresh air for over an hour. We saw lots of birds today, but Mattie was particularly interested in the ducks. I snapped some pictures of our journey. There is something very calming about walking outside, amidst the trees and the water.
Today I received an e-mail from Barbara, my mother-in-law. She asked me a good question. She wanted to know how Mattie could have an absolute neutrophil count of 500 and still be considered neutropenic. Also she wondered if he was neutropenic, then why wasn't he sick and in the hospital? In the past when Mattie became neutropenic he also developed a fever and had to be hospitalized. This is the first time so far, where Mattie is neutropenic and yet feeling fine. So we are journeying a path I am unfamiliar with. In order to understand what neutropenia is, it is important to understand what a neutrophil is! Neutrophils are a type of white blood cell (leukocytes) called granulocytes. Neutrophils kill bacteria/pathogens by engulfing them (phagocytosis). Neutrophils are produced in the bone marrow along with other blood cells. The mature neutrophils leave the bone marrow and enter the blood stream (peripheral blood). A neutrophil has a lifespan in the bloodstream of 6-10 hours.
Neutropenia is a decrease in circulating neutrophils in the peripheral blood. The absolute neutrophil count (ANC) defines neutropenia. ANC is found by multiplying the percentage of bands (immature neutrophils) and neutrophils by the total white blood cell count. The CBC differential count measures the types of white blood cells (WBCs) as a percentage of the total WBC count. To obtain the Absolute count, you multiply the relative value of each type of cell (neutrophils in our case) by the total WBC count. For example, if a person has a total WBC of 6,000 and his differential shows 30% neutrophils, to figure the Absolute Neutrophil Count (ANC) we multiply 6,000 by 30% to arrive at an ANC of 1800.
The severity of neutropenia is categorized as mild with an ANC of 1000-1500 , moderate with an ANC of 500-1000, and severe with an ANC of lower than 500. The risk of bacterial infection is related to the severity and duration of neutropenia. Sources vary on what they consider neutropenia to be. Some textbooks refer to anything below an ANC of 2,000 to be neutropenic and others use an ANC of 1,800. An ANC of 2,000 is considered to be within the normal range, but keep in mind that the average person has an ANC in the 3,000 range. Everyone has a cycle and in most normal folks the ANC doesn't drop below 2,000. Viruses and bacterial infections can affect neutrophil counts in anyone.
There are many types of neutropenia. Cancer patients often have drug induced neutropenia and receive a drug called G-CSF to help boost counts. People who have neutropenia are at risk of infection. When people have an ANC below 500, they are at risk from infection from the bacteria on their own bodies!
So in a nutshell, Mattie's counts indicate that he is moderately neutropenic. Mattie heads back to the Lombardi Clinic on monday for another blood test. So we will determine at this point whether his counts will continue to drop, or if they are rising. If they continue to drop, then it is quite possible that he still could get sick. But right now, he is holding his own. Because he is technically neutropenic, we follow neutropenic precautions, which entail not going out to public areas with crowds, not eating any raw vegetables or fruits, and certainly little contact with other children. In addition to a blood test on monday, Mattie will also be receiving IV antibiotics that he receives on a regular basis to prevent pneumonia. So we shall be in the clinic for a chunk of monday afternoon. Though this may not sound like fun, in all reality, it gets us out of the house, and I always have Jenny and Jessie in the clinic to help engage Mattie and keep him busy. These are resources I don't have at home, and I can assure you, after hours upon hours of playing with Mattie, I NEED a break!
A special thank you to the Emery family for a wonderful Mexican food dinner tonight. It was a "south" of the border meal day for us. Kristin is a RCC mom and friend, and she is also a physical therapist and I have turned to her on several occasions with issues and problems that I see arising in Mattie's treatment. Thank you Kristin for your input, for dinner, and I hope Mattie will be open to meeting with you soon.
We want to thank Karen for her e-card, and we also want to thank Phyllis (a close family friend) for her lovely card and gifts she sent to all of us. Phyllis sent Peter a beautiful silver angel pin and some cologne, to perk him up on our long hospital days. Phyllis sent Mattie some dinosaur shaped soaps, to entice him to take a bath. Phyllis has a sense of humor and is a cancer survivor herself! She sent us two packs of gum, but not just any gum. The gum is entitled, "Cat Butt Gum." Mattie thought this was a riot! The instructions on the back of the gum box are listed below. We thought it was funny considering our situation.
Cat Butt Gum - 8 occasions to chew this gum!
1) When you suddenly need a to change your mood.
2) When somebody yells at you and you don't want to listen.
3) If you are lack of attitude. Note: chew more than one if you need extra attitude!
4) When you need to refuse.
5) When you want to be picky.
6) When you want to be selfish.
7) When you definitely want to say kiss my _ _ _!
8) When entering Day 3 with no sleep, no shower, etc.
Phyllis also sent me a beautiful silver bracelet that I will wear each day along with my hope necklace. Here is what Phyllis wrote, "When I first saw this bracelet, I knew the time would come when someone I knew would need it. I knew for sure that person was you the day I read about you sitting alone with the medical staff to get the results of Mattie's chest scan. How unfair. No one can possibly withstand the onslaught of testing, terror, and exhaustion indefinitely. I know you have a "Hope" necklace, maybe wearing this bracelet will give you some added perspective and serve as a reminder that the enemy you fight is not as powerful as it sometimes seems."
So I end tonight's blog with the message that is engraved on the bracelet and I will continue to reflect on these words. I agree with the sentiments engraved, but there are times I admit that cancer does shatter some of these things for me. "Cancer is so limited... it cannot cripple love.... it cannot shatter hope... it cannot corrode faith... it cannot destroy grace... it cannot kill friendship... it cannot suppress memories... it cannot silence courage... it cannot invade the soul... it cannot steal eternal life... it cannot conquer the spirit."
Mattie realizes Peter is going back to work tomorrow, so he is enjoying the time he has with him today. He tackled Peter to the floor and then hopped on top of him. I thought it was very cute, so of course I took a picture of their moment together. 
Mattie spent a lot of time playing with his air craft
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