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Pedro Nuno Ferreira

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Unfortunately Jasmina had some bad news, Her white blood cell count went down drastically. She was supposed to be transfered to Sloan Kettering to get the bone transplant but I don't think they can do it with her blood count so low.
I understand she can't really speak anymore because of the sores in her mouth.
I don't know what else they are going to try

:sad2:Hi Paul

The low white blood cell count is possibly Leucopenia or Leukocytopenia...a result of many things like chemotherapy...in such condition the risk of acute infection is very very high...basically she has no defences or very low defences against germs and diseases...in such condition a simple cold can have terminal effects...

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Paul B

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Pedro, it is a horrible disease and it kills quickly. I lost three friends with it so far, all of them in their twentees and thirtees.
I don't know much about Leukemia except it has a few forms, none of them good.
I remember when I was 3 years old a little girl named Georgia moved into the house next to me, she was 2.
We were best friends and were always together more like siblings.
My Dad died when I was 10 and her family was into camping and hiking so they would always take me on these mini vacations.
She got married and moved to Virginia and we would visit every few years. Once we were supposed to go and her husband called me to say she had a bad flu and we should not come.
Then he called to say she had leukemia.
We went to Virginia to visit her in the hospital just as they were shaving her head. She was part American Indian and had long black hair that was about to fall out from radiation.
She died a few weeks later in her early 30s leaving two little girls.
Some day we will have a cure for all these horrible diseases, all we can do now is pray and participate in these fundraisers in the hopes that some of the money will find a cure. It will not seem too important until it happens to someone we love.
Georgia and me 1956
Georgia001.jpg
 

Paul B

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To update Jasmina, she is still in the hospital from I think January.
They have a partial marrow doner and they are going to try next week after three doses a day of radiation. She had shingles from the treatment where her scapl was covered with sores including her eyes and mouth.
One doctor told her Mother Thea, to take her home and stop putting her through this, just let her die in peace, Thea fired that doctor.
Hopefully this treatment will work.
Jasmina had her 12th and last dose of radiation Saturday morning. It has been really difficult for her. She has not eaten or wanted anything to drink for the last 4 days and is completely wiped out most of the time but she is being a real trouper. Thea is extremely proud of her for enduring this with relatively few issues. Thea says that sometimes Jasmina was even able to sleep through the radiation treatment while standing up!!!Saturday and Sunday she will receive thiotepa chemo which will be excreted out through her skin. Therefor she needs to be washed and rinsed off twice during the night otherwise the chemicals will leave skin discolorations. After this she will get yet another type of chemo and then Thursday she will receive the transplant !!! YEAHH !!!!
When they did her line change last Tuesday morning they took the broviac out and she now has a CVC, Central Venous Catherer, that has 3 lines coming out of a vein in her chest. She is now hooked up on a different IV pole with 5 huge machines attached to it.Because of the painful headaches Jasmina is experiencing due to the after effects of the shingles she is connected to a morphine supply. When the excruciating headaches come up, Thea can press a button and morphine is released directly into one of Jasmina's lines relieving her pain.
Jasmina is coping with all this with surprising cheerfulness at times and frustration and anger at other times. All understandable, of course. All and all she is doing great! She is really a miracle child.
This is what the shingles look like on her head. I think they are mostly gone now.
laOFrDAAeRXwTYjnv1.jpg

This was better times with her Mother
tTNHBuQcercCyRxTl1.png
 
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MarkF

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Paul,

My son had cancer at the age of 6, and he was treated at Memorial Sloan Kettering. In fact we just marked 4 years since diagnosis (he's now 10). He had a bone cancer so his treatment was different (no bone marrow transplant) but many of the side effects and treatment aspects you mentioned were the same. I can tell that my son really does not recall the Hell he went through, he is now well adjusted with Thank God very few "late effects" considering his treatment. We were told that he may never walk again as his tumor was off his spinal cord, yet he runs and jumps like any other 10 year old.

The point I am trying to make is that there is always hope and yes these kids are just incredible.

If you want to read more about my son's (his name is Yehuda) journey, Memorial Sloan Kettering has a profile on him on their web page which can be found here:


http://www.mskcc.org/mskcc/html/89984.cfm

http://www.youtube.com/watch?v=5R37oEY59l8

We always found strength in other survivor's stories.

Best wishes for a successful transplant for Jasmina
Mark F
 

House of Laughter

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Paul, mark,

Who are the doctors and nurses you worked with? My wife worked at memorial for 11 years and is now responsible for the childrens hospital at Montefiore.

I am not tooting my own horn here, but thought it might be a nice way to show people how they can offer help to children who fight this fight.

Every year for the past 10 years I have volunteered one week vacation time to spend with these children at Summer Camp - Happiness is Camping is a great organization designated to provide children with cancer the camper experience with the proper support mechanisms for those undergoing treatment.

My wife is the first nurse in green in the video treating the children - all her friends, Jamie, Paulette in the video are all close friends. Scott is the kid who throws his prostheses in the pool for giggles - it's great fun and am glad you guys found Memorial. Some of the most talented doctors and nurses in the world.

Don't just read this, do something.

House
 

MarkF

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My son's oncologists were Dr. Lenny Wexler and Paul Meyers and his surgeon was Dr. Patrick Boland.

Wow - That video was pretty cool. There is a Jamie she was Dr. Wexler's NP, she treated my son too. And then there was Paulette Kelly - she was our favorite Nurse Practioner at MSK, we just saw her about 1 month ago, when we dropped my son's Cancer Camp camp forms. Paulette was great for us during treatment she really spent a lot of time listening to our issues, and helped fight some of our battles with the docs. If you mention Yehuda's name (and Mark) to her she will know who we are.

What a small world
 

House of Laughter

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Mark, that's Awesome - Lenny is a a great Doc - Paulette and my wife are best friends and President and co for the regional Oncology Nurse Practitioners Association. Great to hear about camp - hope I get to meet your son and hoping more importantly that Jasmina is feeling well enough to attend camp this year.

When will Yehuda be there and what is his tribe? based on his age, I think he is a Souix - also what weeks is he attending? Will have to introduce myself - who knows, I may even be his cabin leader this year :-0

too small, way too small.

Jim
 

MarkF

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Yehuda will be attending a different cancer camp, Camp Simcha - Chai Lifeline, thats the one that Lenny Wexler goes to.

Please ask your wife to send Paulette our regards, I'm sure she'll get a kick out of it. Regards would be from Yehuda and his parents Mark & Miriam Furman.

Thanks
 

MarkF

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MSK has a great reputation for certain things, but I commonly hear about people having to go elsewhere to get treatment. I have a friend that had lymphoma and he wanted to try a Bone Marrow Transplant and MSK wouldn't do it, he ended up going to UCLA, another family friend had a son with a brain tumor and again MSK wouldnt do the surgery and they went to Duke. Bottom is line is you always have to be the best advocate and explore all options.

Through MSK and a few other organizations I speak with other newly diagnosed parents to offer some guidance and hope.

Also I am a volunteer EMT.
 

Paul B

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From what I hear, some hospitals do not want to do very risky procedures where the outcome is uncertain. It brings down the rating of the hospital depending on how many people die.
Jasmina has a very rare form of leukemia which is incurable even if this transplant works. She will have it all of her life. The transplant is just supposed to give her more time. She will need more transplants in the future.
Now they radiate her standing up three times a day, she sleeps in the harness.
After the transplant they will repeat the chemo.
I only know Jasmina because my daughter used to work for her Mother and she used to babysit. I personally only met her once. Her mother was born in Holland and she was never married. She has been sleeping in the hospital with Jasmina since January.
I don't know how she got so much noterioty. She has been on the news many times and quite a few celebrities visited her.
I really don't know
 

MarkF

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Yes, unfortunately that is what I hear about many institutions as well. Results and ratings are everything.
 

Paul B

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A new letter from Jasmina's Mom

Good news, according to the doctor's, the transplant is so far successful !!!!!
Her pain is less after they took the stitches out from her G-tube. She had four long wires poking in her body, so no wonder every little move was hurting. So Now I can finally cuddle her again after abstaining for a week. We made her get up and walk on Monday. Her heels were hurting because she did not walk for such a long period so she could only walk very slowly on her tippy toes. The next day she did 6 rounds in the hallway. Yesterday about 10 without any issues and even said "faster mama, FASTER !!"
Getting this nutrition is definitely getting her energy back which is great. It is fantastic to hear her talk and laugh again and I see slowly the sparkle in her eyes returning.
Her left eye is now 3/4 open and looking a lot better.
Jasmina's high blood pressure is finally under control with continuous medication.
Her liver function level was elevated and therefor she had to do a scan yesterday. From what they could see is that the liver and spleen are enlarged and we have to figure out the cause of this.
The food she receives in her G-tube looks like a strawberry milkshake. It is administered at 25 ML per hour and every time they tried to give it at 30 ML an hour, she threw up. Milkshake all over the bed.
At first, she received TPN ( nutrition thru her lines) simultaneously but they needed to stop that because of her liver condition. The liver might be damaged as a result from the radiation which can happen.
In order to receive the right amount of calories she needs to receive the strawberry milkshake at 40 ML an hour. If she can do this without rejection, then we can go home !!!
Her hair is growing really fast now, soft and sticking straight up kind of what a baby elephant feels and looks like. It is so surreal to hear people say, " Oh, WOW, your hair is sooo long !!!" while is is only 3/16". Next week probably 1/4". ( I am thinking extensions already, HA!) But this rapid hair growht is a side effect from the Tacrolimus. This is the medication to prevent Graft versus Host disease, or transplant rejection if you will.
This is the biggest concern post transplant. Next to us is a little boy who had 10 out of 10
( Jasmina had a 9 out of 10) and he even got G.v.H disease and it is not pretty.
Another little girl of who's mom I became friends with, past away a little while ago. Her heart just gave up after the umptiest round of chemo. That reminded me of the time back in February when one particular chemo send Jasmina's heart in overdrive together with a fever of 108F ( this number does not even come up in the Fahrenheit to Celsius conversion chart because theoretically, it should not exist) and sometimes I am still surprised that she made it. Oh well, better not get me started.....
In the meantime, I should not have an excuse anymore to eat ice-cream every night in the hospital. I had a serious bout of what I call frustravings, when you are nervous frustrated and only ice-cream can make you feel less anxious and somehow elastic waist pants,
( thank you Norma Kamali) make you oblivious to the obvious repercussions I now will have to pay for the hard way.
So in a nutshell, Jasmina is doing fantastic and I got fat !!!
 

Paul B

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Jasmina's bone marrow transplant failed.
Here is a little of what her Mother wrote.
"By now the red blotchyness has darkened and a rash developed on her hands, knees and feet. Her eyes so yellow that they look fluorescent green, her tears are yellow, her skin has an orange undertone like you see in bad make-up and the palms and bottom of her feet red. Her liver and spleen enlarged. When they took a skin biopsy today, she screamed in pain and the doctor told her that she was allowed to punch him after."
The doctors told her Mom to take her to Disneyland and have the best time of her life.
There is nothing else they can do for her.
 

Paul B

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Yasmina was invited to the White house to have Thanksgiving dinner with the President.
She was sent there by a foundation that contributes to things like this.
Her Mother went to wake her up this morning and she was non responsive.
Yasmina now has severe diabetes and they don't know if she had a seisure.
She is back in the hospital where she has been in for almost every day since last January.
Quote:
So the doctors have a preliminary diagnosis based on Jasmina's MRI. They think she has Posterior reversible encephalopathy syndrome (PRES). This is a swelling of the white part of the brain which can cause seizures as well as other complications. In Jasmina's case it is most likely caused by the combination of tacrolimus (Graft vs. Host medication) and high blood pressure. The good news is that this condition is treatable. Hopefully the doctors are correct in their diagnosis. They will change her G vs. H medication and work on controlling her blood pressure and electrolytes. They will need to monitor her in DC for several days. The doctors are also planning a spinal tap. They do not see any signs of bleeding in Jasmina's brain and they say they caught this early so that is also good. I will keep you posted once the diagnosis is confirmed or changed.
 
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Paul B

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Greetings from Washington. (from Thea, Jasmina's Mom)
Well this has been an enormous adventure. First I want to say to all parents;
Always listen to your instincts even if it means canceling an appointment with the 44Th president of the United States.
First the good news. All is well and we will go back to New York on Thursday.
But let me start with the beginning.
Through the "make a wish" foundation, Jasmina was granted her wish to meet president Obama last week.
Monday the 23rd, when we were on the way to a clinic appointment, Jasmina spotted a poster of her friend Rihanna who happened to be around the corner from our home to do a signing of her new CD. So that evening after she received platelets, she said that she wanted to say hello to her. I made a phone call and we went. There was a line around a few blocks but naturally Jasmina received a VIP card. A few moments after, Rihanna stepped out and was genuinely overjoyed to see her little friend.
I did not want to make this a spotlight thing or photo opportunity just a quick private Hi/Bye before Rihanna would start her signing. I wanted to take Jasmina home again since her energy has been low. Then it dawned on me that Jasmina would meet Obama two days later so I asked her to sign a CD for the president. She wrote; "you ROCK prez, love Rihanna".
Perfect gift to bring to the white house even though the CD is Xrated but I guess Barack can handle it. Then within seconds all the camera's were on top of them and pictures appeared all over the news, blogs and websites.
The next evening we were on the plane to DC for the BIG day. Jasmina was extremely exited to be on a plane again because we used to travel quite a bit and it has been almost a year. Everything was great. We arrived in DC and were taken by limo to the hotel. I woke her up for her 6 AM medicine in the morning and all was fine. I let her sleep a bit more for the big moment ahead and was on the other side of the room ironing both of our White House outfits when she started complaining about pain at the site of her feeding tube. So once again, I removed the d... thing. This time a huge amount of gas escaped unlike the vulcano-like tummy content a few weeks earlier. She felt better. Then moments later she cried in pain again and I called the lady who was waiting for us in the lobby if we could be a half hour late but she told me that the white house is on a very tight schedule. (of course they are, what was I thinking !!!!)
At this point Jasmina's speech became incoherent and she had pain in her heart. She also wet the bed which is unusual. Then her eyes became unfocused. I pressed the alarm button of the hotel phone and then everything went really fast. The hotel security and Ambulance staff were phenomenal and we could not have lost many seconds. She was not breathing on her own and they put her on oxygen immediately. Then they asked her to open her mouth. By this time having been so long in the hospital, Jasmina can do this in her sleep but when she did not comply and I saw that her teeth were clenched, you know. Something was REALLY wrong.
In the ER, about 15 doctors, nurses hovered over her tiny body, putting tubes and IV's all over the place. Frantically I called Dr. Carroll in NY who knows the doctors here. All came over, post transplant doctor, neurology, oncology etc. Including the VP of oncology who happens to be Dutch. We were in good hands. After many tests and more tests, the conclusion was that she developed PRES. Posterior Reversible Encephalopathy syndrome. The first word that stuck to me was "REVERSIBLE !!!" This PRES is due to one of the medications, Tacrolimus (why did no one ever tell me about this side effect???) and causes swelling in the white part of the brain (I saw it myself on the brain MRI). This together with her high blood pressure caused a seizure. The worst went through my head. Brain aneurysm, blood clot, brain dead, vegetable etc.
So there we are in the emergency room with a social worker on one side of me and a priest on my other side and I am thinking, it was not supposed to go like this. I was supposed to make an attempt to pinch the president's tush at this very moment. (or at least fantasize about doing so).
Later we were transferred to the ICU. There she was, just laying there for two days, out of it. She still has no recollection of these two days. A tube in her nose, her private, her mouth attached to an incubator, in both of her hands and IV and her head attached to thousands of little wires to monitor more possible seizures. Her hands cuffed to the side of the bed like you see in movies about loony bins, so that she would not be able to tug one of the tubes.
The white house called for an update and the president wanted to speak to me but I was in no mood to speak to anyone. I mean whatever can you say in a situation like this.
My friend Robin flew in from LA. They wanted to send her away because the hospital is closed because of the swine flu to anyone who is not a healthcare worker, patient or parent. No family, siblings, volunteers etc. She offered to get the HnH1 shot but was told that they did not ha enough even for the people who needed it. Thank GOD for my new BFF, the Dutch VP of oncology who arranged two swine shots for us.
Then neurology, after studying the brain MRI, told me that she might have some brain damage and vision impairment thing going thru your mind is then, OKAY, not a vegetable, she will just need glasses.
The next morning she was able to follow commands like squeeze my hand etc. Also able to reconize how many fingers he doctor was holding up so they were very pleased with her progress.
Later that day when Jasmina woke up, the first thing she said ( well not said, because she was still not breathing on her own and was not able to talk with the fat tube in her mouth, taped to her face), she wrote down; "How come it is Friday already?" the second sentence; " What happened to Obama?" At first she did not believe me that it was Friday and was angry. Then in no time her attitude was back and she was playing her DS.
That's my girl !!!!! It would not be Jasmina if she did not get out of this. She clearly is not brain damaged and has no impaired vision, HOORAY !!!!
Later the same day I received a call that the white house was going to call me between 5.30 and 6.30 PM and that it would show up on my phone as "unknown".
The call came at 5.05 PM. I of course was not sure since the call came early and on top of that I rightfully presumed that a representative would verify my name and put me "through", so I said, "who's this?" . And there it was......."this is Barack Obama" in the nicest sexiest voice you can imagine. I wanted to say, " say it again PLEASE ?" but was able to contain my excitement ( the president has my cell number, how cool is that?) so we chatted a bit. He asked all about Jasmina's condition, recovery etc, and I thanked him for the oppurtunity. He asked if she was resting and unfortuntely, she was sound asleep and I could not wake her up. So he said that when she is up to it, to call his office and he will talk to her. Jasmina is extemely dissapointed that she did not meet him. The wonderful people at the "make a wish" foundation assured me that it will be rescheduled for a later date so that made her smile again.
That is it for now. We will be home soon !!!!!
 

Paul B

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Tomorrow I play Santa Claus in NYU medical center on the floor that houses the children in the last stages of cancer. Coincidently, Jasmina is a patient there as she has been since this time last year so I will get to see her and hopefully make her a little happier.
She is in isolation so I will have to talk to her from the door. My daughter who used to babysit for her will also be there helping me with the gifts.
They don't allow pictures to be taken which is a good thing.
It is not my favorite day of the year as it is the most depressing thing I have ever done.
But Santa has to be Jolly no matter what.
I hope she is doing somewhat better but I am not getting my hopes up.
Many people have no idea how sad it is for these kids and the worst part is that we can't do anything immediately about it.
 

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