Friday “morning” I woke Ashtyn up at 11:30 a.m. and headed to the hospital for her bone marrow aspirate. “Why do they have to do it so early?” she asked with exhaustion. “It’s at noon which isn’t early.” (It really is early to her, since she continues to go to bed around 1 a.m. and wakes up for the day around 1 p.m.) Once at the hospital we valet parked and started walking down the hall towards the elevators. After 50 feet Ashtyn realized she needed a wheelchair. I found her one, wheeled her to the elevators with her mask secured around her face, and went up to the 4th floor Oncology Clinic. There is never a wait in the clinic. Her vital signs were taken right away with a blood pressure of 104/60, heart rate 100, and temperature of 98.2F. Perfect. Her primary fellow and attending doctors assessed her and the nurse changed her sterile broviac dressing. Just a typical day doing what we do without anxiety or fear.

A bone marrow aspirate has become typical as well. Ashtyn has done the procedure five times so far. After the clinic I wheeled Ashtyn to the Rapid Treatment Unit. Lindsey greeted us as always with the ipad and the Disneyland Explorer app already playing. She also showed us that Ashtyn’s picture was on the front page of the Primary Children’s Hospital April newsletter because she did an interview for storycorps.org a few weeks ago. Ashtyn thought that was so cool. When the O.R. was ready she knew the routine and had no hesitancies. She walked into the operating room, laid on her right side on the table, the anesthesiologist pushed Propofol into her central line, and Ashtyn quickly fell asleep. Upon awakening she told the nurses she had been sleeping for four days. When they informed her that it had really only been 20 minutes she sweetly trusted them. After she drank a slushy and ate the plain potato chips she always picks, we headed home.

Medical Tidbit: Cancer cells often collect in the lining of the spinal canal or brain in patients with leukemia. This results in central nervous system leukemia. Even if cancerous cells aren’t detected, patients still undergo central nervous system prophylactic chemotherapy to ensure that no leukemia cells are present. While the bone marrow aspirate was done (removal of a small amount of bone marrow liquid for examination) she also got a lumbar puncture and the chemotherapy drug methotrexate was again injected into her spinal fluid.

At 6 p.m. I received a phone call from Ashtyn’s oncologist with the preliminary bone marrow aspirate results. Looking at her bone marrow liquid at Primary Children’s there was no evidence on any cancer cells. A patient is considered in remission if there is less than 5% cancer cells among normal cells. In order to have a bone marrow transplant there must be less than .01% detectable cancer cells, so basically no evidence of any cancer cells whatsoever. Her sample was sent to Seattle Washington where they have state of the art technology that enables them to get an accurate reading on the percentage of cancer cells present. In two days the results will be known. The doctors believe Ashtyn will still have detectable cancer cells because she only had one effective round of chemo. If there are cancer cells present, she will go back to the hospital in five days and begin another round of chemo. If there truly are no cancer cells, preparation for a bone marrow transplant will begin. Either way is good news. Because the last round of chemo worked so well and her bone marrow has no visible cancer, she is allowed to stay home for a longer period of time. Physically it’s a huge benefit that allows her body to build more white blood cells. Emotionally it’s a huge benefit having a break from the hospital and enjoying time at home.

Friday night Ashtyn had a couple friends over, Spencer who survived Rhabdomyosarcoma and Kaylee. Though none of them go to the same school, all three have known each other for years. They enjoyed a delicious Olive Garden take-out meal, which Ashtyn had been craving for a month. I informed her, “Ashtyn, as I was walking out of the gym today a woman approached me with such love and kindness. She handed me money and said, ‘you don’t know me but my daughter and I have been touched by you and Ashtyn. I want to pay for her Olive Garden tonight.’” With a surprised look on Ashtyn’s face she said, “Mom, really? She was really thoughtful to think between the lines. She read a huge blog post, took one little sentence about Olive Garden, and thought about how she could serve.”

After dinner they watched my all time favorite movie “Les Miserables.” I knew nothing about the story of Les Mis until I saw the movie at the end of December. There has never been a movie that touched my heart so deeply. I bawled like a baby and wanted to be a better person after watching it. I remember after the movie I called Ashtyn and cried as I told her what an amazing movie it was. Ashtyn saw it three times before being diagnosed with cancer. I love the lessons that can be learned from the movie. Here are a few:

Perspective: “Tomorrow we’ll discover what our God in Heaven has in store.”
Happiness: “Life’s great happiness is to be convinced we are loved.”
Sacrifice: “Let us sacrifice one day to gain perhaps a whole life.”
Love: “Take my hand and lead me to salvation. Take my love for love is everlasting. And remember, the truth that once was spoken, to love another person is to see the face of God.”

In the almost three months since Ashtyn’s diagnosis, we have experienced such love, service, sacrifice, and compassion from family, friends, old neighbors, new neighbors, and strangers. Notes, gifts, and kind actions have touched us greatly. We have also experienced many tender mercies from God. The lessons learned about faith, trust, hope, optimism, patience, and love have been invaluable. Our perspective is forever changed.