Journal entry by Shannon Neil — Nov 3, 2019Madelyn got an official diagnosis of B Cell Acute Lymphoblastic Leukemia (ALL). 
 It is cancer of the blood and bone marrow. Blood cells that are made in the bone marrow include the white blood cells (WBCs), red blood cells (RBCs), and platelets. WBC are the infection-fighting cells, RBC provide oxygen and energy to the body and platelets help blood to clot. Leukemia occurs as a result of abnormal growth of immature blood cells called blast cells. The blast cells grow out of control and crowd-out the normal cells in the bone marrow and spill out into the bloodstream. As a result leukemia may be found in other parts of the body such as the lymph nodes, liver, spleen, central nervous system (brain and spinal cord ,SC), skin and organs. Madelyn’s spinal tab came back clear so she doesn’t not have any blast cells (leukemia) in her brain or SC. This was great news. She would have needed radiation if it was positive.

Leukemia is not described in stages 1-4 like breast cancer. It is described in risk groups, standard and high risk. Currently Madelyn is in the standard risk group. We have a few more test to get back which could change that. However both risk groups have a very good prognosis. You just treat them a little different.

She had a good morning especially considering she could not eat until after her 3 PM surgery. She was sedated to have a spinal tap and place her port. The port is a small metal disk that is placed under the skin on her chest. It is attached to a catheter (a thin, flexible tube) that is threaded into a large vein above the right side of the heart called the superior vena cava. A port is used to give intravenous fluids, blood transfusions, chemotherapy, and other drugs. She will probably have the port for 2 years. 

She had her first small dose of Cytarabine (chemo) into the spinal fluid during the spinal tap.
That evening she when the meds wore off she was in some pain from the port and was over all just exhausted. She struggled to get comfortable early that evening but after a good dose of pain meds she slept decent that night from 12-6.