Made it to see Wicked

October 30, 2014.

I read the book "If I Stay" to Cass whenever we are by ourselves since she's in hospital. This is our very quiet and sweet moment which I enjoy very much. However, it also gives me hard time to continue on reading the story not because of the fancy and big words the author would like to use in every paragraph, instead it is because I have to hold my tears when reading the story……..I paused many times to swallow my tears and suppress my emotion in order to continue on as I didn't want Cass to know that I was feeling so sad with the story. I was reading her a story but indeed somehow it was also "her story"……. the story of what she's gone through when she was 7 and what she is going through now! The story composed in the book was a beautiful but sad story. The incidences that the girl in the book has to go through is, to certain extent, similar to what Cass has been facing. I identified to her situation, and the story reminded me of the time when Cass was in critical care unit 7 years ago.

Cass took the 6th session of her new 8-day radiation treatment this morning (Thursday Oct. 30). It appeared that Cass’ pain in her right thigh was better managed. She could sleep longer hours without waking up in the middle of the night with pain as compared to what she had in the last few days. Cass can move around with more flexibility now as the hospital has removed the IV and given her the portable pump instead. Cass needs to get used to using the pump which in turn controls the dosage of the pain medicine that's needed. The pump so far seems to work better since Cass is no longer required to wait for the nurses to adjust the dosage through IV when the pain spikes. When she was on the IV, she experienced longer pain while waiting for assistance despite the fact that the medical team had already been taking good care of her and that everyone on the team was trying hard to address Cass’ needs very promptly whenever the team could. 

A few of her friends came to visit Cass today. Even though Cass was still feeling tired most of the time, she was so cheered up right away, suddenly forgot about her pain and became so into the chatting as soon as her friends showed up in her room. 

With the portable pump, Cass did go out tonight to enjoy the “Wicked” Yay! She had been so excited and looking forward to this performance not only because she could watch the musical she liked, but because she could also meet and treasure the moment of being with her loving friend, Sarah. They enjoyed the show very much but she did have some pain, on her arm as well. When she got back to her room, her nurse gave her other pain medication right away. Meanwhile, she was so excited to talk with the nurses about Wicked. We thank God for letting her to see Wicked and friends and family's great love and prayers!

Being loved makes us brave!‏

Cass is still in pain. It has been greatly bothering her since last Saturday. Quite often she woke up in the middle of the night because of the heavy pain. The medical team has been trying hard to look for the cause of the pain, and a solution to reduce it. For flexibility, Cass will soon receive a pain control kit from the hospital. It is a small pump with pain medication in it. By attaching the kit to her body, Cass can take a break to be away from the hospital. She can go out with her friends for a short period of time. Indeed, Ca has been looking forward to watching the musical "Wicked" this Thursday. She can flush more dosage of the pain medication when she feels painful. 

Today is the 4th day of her 8-day radiation. Before she went over to PMH for the radiation, my cousins (Amey and Leona) showed up in Cass' room together with my other two cousins (Karen and Samantha). Cass was so happy when she saw Amey and Leona, and particularly excited to see Samantha and Karen who had flew all the way from Hong Kong to see her. They chatted happily and took precious pictures together. At the end, Cass was so reluctant to leave them and went to attend the radiation session. 

Tessa dropped by to see Cass and they enjoyed the new album of Taylor Swift together in the morning. In the late afternoon, Fiona, Cass' classmate from Northlea, came to visit her as well. 

Thanks for all these loving visitors - family members and friends who have cheered up Cass a lot and definitely their presence has made our day easier, and our time has flown faster in our difficult days.

Please continue to join us in praying for Cassidy. Pray that she can remain strong and positive to her situation and the coming medical treatments and that her pain with be managed with the portable pump and she won't be suffering from severe pain.

Update - Monday (Oct 27)

Cass is feeling tired and sleepy on Monday (Oct. 27). The pain in her right thigh is still there and she feels numbness as well. The doctors changed the morphine to hydromorphine at midnight, and adjusted the dosage for her as she's feeling some heavy pain every few hours. She was so happy to see Heather again in the morning of Monday when it was about time to wake up. Heather played her a song with her ukulele and got Cass more riddles.

Heather is playing ukulele for Cass

Cori and Ryan, the coaches from Flames of Variety Village (Cass’ swim team), visited after Cass had just come back from PMH for the 3rd day of her 8-day radiation. Cass was so excited to see the tattoo design for her from her club and the lovely presents from Penguin, the swim team in Kingston. (you would be amazed to know how much Cass has missed all of you and the races with you all!)

Cori and Ryan, coaches from her swim team's visit

Cass took a nap and woke up just at the right time when Sarah and her mom were about to visit. They had some lovely time to chat with her and planned a bit about this Thursday night for Wicked since Cass asked the doctor if she would be able to see the Musical on Thursday. They ordered a portable pump for Cass such that she could go out with it. However, her oncologist has some concerns about Cass' situation, and will be discussing her health condition and the treatment plan with us in the next two days. However, he doesn't want Cass to be involved in the discussion this time. My heart sank.....

Sarah & Cass

Once again, thank you so much for all her loving friends’ support and prayers. You are the rainbow in her cloudy days. Please continue to pray fervently for her.

One thing impressed me...at the end of the day, Cass was turning on her computer and working on her homework. (However, she was struggling with the pain just 15 minutes ago and had asked for an extra dose of hydromorphone before she started her homework. Cass actually won't be able to go to school these few days)

Homework time

Pain eases a bit, at Sickkids for 1 or 2 more night(s)

The pain in the back of Cass's right thigh appears to be better controlled through IV. Having stayed overnight in the hospital, Cass received better medical treatment and close monitoring by the nurses and doctors there. Even though the pain has not been totally suppressed, it is improved. The doctor stated that Cass might feel more pain in the next few days or so as radiation would cause the affected areas to swell up slightly. This may in turn intensify the pain that is already there. The doctors are still working on a better plan to ease her pain. They are now switching her to the other pain control medication. Cass will need to stay at Sickkids for another night, or for a couple more nights. However, Cass asked the doctor if she could be able to go home on Thursday to see Wicked.
Today is the 2nd day of her new 8-day radiation as well. She was very tired and didn't want to move too much as she found it very painful every time she tried to move around. Please continue to pray for Cass, pray that her pain can be soothed, and the new radiation round will be effective!

Heather was reading the comments from her blog to Cass.

A beautifully said comment that touched all of our hearts

Cass to Emergency and Stays for Tonight

One day I might feel hope ahead of us, but the other day I could find everything to be so helpless. The ups and downs have been fluctuating so frequently in the past few months. I just wanted to find a place to hide. However, by the end of the day, the Bible verse (Matthew 6:34) came to me.... "Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough troubles of its own." 「...一天的難處一天當就夠了。」..... I realized that I needed to take a good rest and give the worries to our Lord as I understand that challenge may come every day ........ I need to refresh and re-organize myself before I can stand next to Cass and battle together with her against her cancer!

Cass felt so sick yesterday. She is in great pain even though she has taken the medication. Originally, Cass has been invited to participate in the Para Swim Camp, which is currently held this weekend in the new Pan Am Pool at U. of T. Scarborough campus. Even though she was not feeling well, she tried hard to get up a few times in an attempt to go there as she had been looking forward so much to meeting her friends in the para swimming group. We finally managed to get her to the car at around 3:00 p.m. yesterday. Yet she was very sick and threw up badly in the car. At the end, we could only return and let her rest at home. She's been struggling with the pain and nausea the whole day yesterday as well as today. The pain did not appear to go away even though more morphine has been applied.

As per the schedule set on this Thursday, we took Cass to Princess Margaret Hospital for the new round of radiation this morning. The treatment this time will focus in two specific areas for a period of 8 days. It will deal precisely with the sacrum and the lower back (L1).

Getting ready for the radiation at Princess Margaret Hospital

Since Cass is very sick and in pain this morning, so we took her to the "Emergency" right after the radiation. She was really in pain even with all her mediation taken. The doctor just came to assess her. However, she needs to be seen by another specialist. Her nurse and the doctor from the palliative team called yesterday to give me the instruction for her medication. They originally asked that we brought Cass back to the hospital should we find the pain and vomiting to be continuing. However, after the diagnosis by the doctors just this afternoon, the medical team decided to keep Cass in the hospital tonight so that they can have the detailed examination on Cass to determine the cause of the severe pain. 

At the Sickkids Emergency

Please pray for Cass that the doctors will find the way to ease her pain and her sickness, the radiation will work to control and stabilize her tumours, and the tumours do not spread to other part of her body. Oh, God has mercy on Cassidy! 

Update of this afternoon

After the Radiation Oncologist and the Spine Specialist, from Princess Margaret Hospital, reviewed Cass' latest MRI report, they believed the pain at the back of her thigh was very likely caused by the tumors at the sacrum, which was one of the areas that had received radiation treatment two months ago. Anyways, tumors in the same area are suspected to be bothering Cass now. Given such diagnosis, the medical team plans to re-treat the area one more time, specifically to one of the small areas at her right sacrum. They will lower the dosage at this time and span the whole radiation process over a period of 8 days. At the same time, they will also treat her L1 location and maybe her femur as well. They need to review the CT scan and do more planning work before Cass can start this round of treatment. If everything goes smoothly as planned, the radiation will start this Saturday morning. Please continue to pray for God's healing power and His wisdom for the medical team so that the treatment can be performed to Cass' best benefit, and that the tumors will be controlled and not cause the nerve problem and pain to Cass.

Cass felt much better after taking more pain killers 

and a nap on daddy's shoulder

Possibly Another Round of Radiation...

While we were still looking for some other ways to help Cass to relieve the pain in her right arm, and to improve her arm's movement accordingly, she had great pain at the back of her right thigh this past Tuesday. The pain does not appear to go away but has been bothering her in the past two days. To find out the cause of the pain, we went to Sickkids yesterday and today to meet with the specialists. The pain in her thigh is a lot more than that in her right arm. During the diagnosis, the doctors reviewed her recent MRI report and believed that it could be the tumors on her L1 location. Because of the location and size of the tumors back then, they had never been treated with radiation. However, they might have grown larger in size and are compressing Cass’ nerve on her right leg. The medical team tried to respond Cass’ case with some urgency, they will send Cass to Princess Margaret later this afternoon to see the radiation oncologist there to re-assess her condition and to find out whether another round of radiation will be required and if it could start immediately. To ease Cass’ pain, she has to double the dose of the morphine that she has been taking recently. Please continue to pray for her that the pain can be reduced, that the tumors can be controlled by the newly proposed round of radiation, that the hospital will soon be able to come up with another new chemo drug that would be suitable for Cass to try, ...........

Decision made...

{Cass, we know that you love your daddy and mommy. Indeed, we love you very much too and that is why both daddy and mommy couldn't let go of our own standpoint easily on the decision of whether the new chemo drug should be taken. We are so sorry to unintentionally put our daughter into such a painful dilemma yesterday! You are truly brave and courageous, and are so thoughtful in understanding two totally opposite decisions, of daddy's and mommy’s, in an attempt of not hurting our feelings. You have actually inspired me a lot!}

Since we couldn't reach a consensus on the issue of whether or not to try the new chemo drug, we all decided to wait for the report on the MRI that Cass had just taken yesterday, and then to review the report with Dr. Baruchel today prior to making a decision on the next move. Dr. Baruchel gave us the MRI reports and the bone scans, he explained to us the condition about Ca's right arm, tried to give us a brief analysis of the new study drug in relation to Cass’ situation, and spelled out all the pros and cons of the chemo to the best of his knowledge. When he came to the end of his overview, we tried to ask Cass for her preference. We did that because Papa Andy and Mama Carmen were holding firm to their opposite beliefs. Anyways, I told Cass that I would support her in any decision she would make. 

Cass' tears started running before she could respond a word. So the doctor and the nurse left the room and let the family discuss alone. Cass felt pain as every single word slipped from her month, tears dropped from her eyes, "I can't just go without trying anything!"....."I prayed that God would guide me to decide from the MRI report; if the tumours have shrunk, I wouldn't take the new drug; if the tumours were growing, I would take the new drug. But now my tumours didn't get bigger or smaller. I don't know how and which way I should go!" ……..When I saw Cass getting stuck in the dilemma, then I said to her that it's ok if you couldn't make any decision right now. Even if we couldn't make a decision, we could still continue to pray for it. With a long pause, Cass continued to say in tears, "but I don't feel right without daddy's support." Papa didn't say anything but wiped her tears! She finally made the decision, and the chemo would be scheduled this Monday (Oct. 20). However, we will continue to pray, pray that we will have peace among our family, and that this is indeed the way He leads us to. After all, Cass is right...as I won't feel right either without papa Andy's support!

Cass suffers physically and psychologically in her cancer, the doctor mentioned to us that the chance of recovery for her right arm is very low. He further explained that the tumor is located on the nerves causing inflammation in that area, and that's why she is having more pain and less mobility in her right arm even after receiving the radiation. Hearing her prayers to cope with her daily struggle which includes her pain in her right arm, catching up with her school work, being able to integrate in her school environment and the treatment plan, and seeing her continuing to work hard on her homework (just like last night when she went to work right after the MRI from the hospital), Cass expresses her bravery in facing her everyday's challenges. She is thoughtful and cares about our feelings. I suddenly couldn’t hold back and cried out, "God have mercy on Cass".

Please pray for God’s mercy on Cass. Pray for the mercy from the Almighty Power on Cass. We need God’s direction to the way for Cass's treatment, and trusting that God will make all things right.

(While I was preparing this update, I received a phone call from Dr. Baruchel who informed me that Cass might not be eligible to the use of the new study drug as planned. Since Cass has recent nerve problem in her right arm, and nerve problem could be one of the side effects from this Chemo drug, hence the drug company found that the planned new chemo drug to be not suitable to Cass at this time. As such, the chemo this Monday was cancelled and the medical team would look for another appropriate drug for Cass in the mean time.)
 

Please pray

Cass had gone through the whole process of medical testing and scans last week in preparation for the study chemo drug which was originally scheduled to take place tomorrow (Thursday). We finally came to a point where we needed to let the hospital know of our intention. When Cass went down to Sickkids for blood work yesterday, Denise, the nurse, went over the details of the new chemo with us which we had already gone over before. At the end of the session, when we were asked for our consent on whether or not to take the chemo, it did not seem to be an easy agreement to make. We were unable to draw a unanimous conclusion, we were once again unable to convince each other and come to a consensus. However, we all well understood that even though we had drawn different preferences, our preferences were made simply for the best interest of Cass. Papa Andy does not feel comfortable about the chemo as it may further deteriorate Cass physically; however, Mama Carmen would like to try it since the study chemo may be helpful in controlling the tumours in the end. Anyways, the hospital has to hold back the chemo tomorrow. As part of the preparation for the new chemo, Cass will still need to take another MRI this evening for an update of the condition of the tumours before the new chemo drug is applied. The hospital has also indicated to us that they could arrange to carry out the chemo on Friday (Oct. 17) or this coming Monday (Oct. 20) so long as our consent can be made in the next one to two days. Please continue to pray with me that we can grasp the guidance from our Lord. I once thought about withdrawing from this decision making so that I would not need to face the difficulty of making a decision. Yet I couldn’t. But I continue to pray that we would remain calm and humble and take His steps as we know that He will prepare the best for us, regardless if the direction is in favour of ours or not.

Cass with Denise (discuss about the study chemo drug again)

Cass's waiting for her turn to do the MRI 

(she said it's probably the last time to wear 

the pink one as it's too small for her now)

Cass's about to do the MRI

Give Thanks with a Grateful Heart!

Happy Thanksgiving

Happy Thanksgiving!

We are so thankful for all of our amazing friends and family! Love you all

"Be joyful always; pray continually; give thanks in all circumstances, for this is God's will for you in Christ Jesus." 1 Thessalonians 5:16-18

We felt warm and thankful to have an early Thanksgiving dinner with the Kerr family!

Update on Cass

Cass is still having difficulty to move her right arm, and the pain and the stiffness on her neck are still bothering her a lot. The doctors know the problems yet we are unable to do anything to improve the situation for the time being, we can only wait. To prepare for the new chem drug, pending on our final decision, Cass went through a series of tests and a bone scan again yesterday. Then, another MRI will be followed prior to the chemo. Her neck, shoulder and right arm are so stiff that some simple bodily movements, which were easy for Cass to do with no problem before, have become a hurdle for her now. These simple movements are painful. The medical team cared so much that they got the physio group to help Cass perform some simple stretches in an attempt to loosen up her neck, shoulder and the right arm. Seeing Cass bearing such pain in her day-to-day routines and given that she has still been trying hard to keep up with her life, including her school work, without a sign of giving up, I really feel proud of her on one hand and feel a pinching in my heart on the other hand. She has been so courageous since day one in facing her challenging health condition, in taking on all the medical treatments including surgeries, in bearing the side effects from most of the medication, blood work, injections through the veins for scans . . . . . . . .  very often, I found myself to be too scared to see needles and blood . . . . . . not even dare to watch during the medical processes. But now, I think I should watch them to have a sense of Cass’ feeling, to identify with her, to sense her pain as well.

So far, neither chemo drugs could induce positive effect on the tumours nor could radiation or surgery help because some of the tumours are at the inconspicuous locations. The doctors still think that we should let Cass try the study chemo drug, which can be scheduled at the soonest next Thursday (Oct. 16/14) upon Cass’ consent. We may end up accepting such new drug reluctantly; however, at this moment, we are still not so comfortable with the drug since it is so new and there is too few past cases to confirm the potential side effects that may cause. We have been praying fervently for God's guidance on Cass’ next treatment. Could you continue to pray along with us?  Thanks!

Updates of school and treatments

Cass has been working very hard to catch up on her school work after she had started her school in early September. She was so happy to tell me that she managed to finish most of her outstanding homework and write the tests for Unit 1 for her English, and Food & Nutrient classes. Because of her frequent medical appointments, she had to skip classes from time to time but she still managed to go to school almost every day. She thanked God for being able to arrive at school on a daily basis in her daily prayers. To me, I have got back to my work routine. I thank God for lots of amazing and loving people in my life. I could never say thanks enough for the great support from my boss and my colleagues at work, and the encouraging notes and refreshing little presents from friends and brothers and sisters from our church. Having Cass's friends dropped by to spend time with her was also always a big support to her, especially when she was struggling with the pain in her arm and her busy days with her school and Sickkids appointments.  All these acts and gifts had very special meaning to me and lifted up my spirit and Ca’s spirit in our daily lives. I thank God for the amazing people He has placed around us all the time.

"And we know that in all things God works for the good of those who love him, who have been called according to his purpose." Romans 8:28

We met a new Spine Doctor at Sickkids yesterday (Friday). The doctor checked Cass's physical condition and her MRI. Then he said that the option of removing her tumours by surgery might not be viable since there would be too many other things that need to be taken into consideration for such a surgery, and there's too many that would need to be removed! Similarly, to do something through the surgery to improve the mobility of Cass’ arm may not be a good idea again for the time being. He said we would wait for another two months to see if her arm mobility would be able to recover. Instead, he said Cass should continue on taking chemo or radiation whenever we would need to control her tumours. Surgery should only be considered to be the last means since surgery could create some other problems to her.

Therefore we needed to go back to the discussion of whether we should take the study chemo drug. Cass' oncologist wanted her to start the new drug once her last radiation has settled for 21 days. By then, Cass will have a long series of tests and scans to do again before the use of the new drug. Papa Andy is still not comfortable with the new drug and we are praying for God's guidance for her next chemo. Please continue to pray for Cass, and God's guidance on her next treatment.

Cass was trying hard to lift up her right arm to post as the panda at the Orthopaedic clinic to meet with the Spine doctor

Cass at the cancer clinic