Radiation (take 3)

Emmett started radiation this week.  He has done wonderfully in every meaning of the word.  He isn't nervous or scared in any way and actually seems to look forward to getting his treatment each day.  He sits perfectly still while they put on his radiation mask (which holds him perfectly still during treatment) and at the same time Katy or I start a playlist of his favorite music which helps him stay calm and focused (and pumped up!) while they verify his positioning and then administer the focal radiation after everyone leaves the room.  (More on the playlist later....maybe.)  They tell us that the radiation beam is only on for ~30 seconds or so. All said, he's in the radiation room less then 15 minutes and then he comes and finds us in the lobby of the Francis H. Burr Proton Therapy center and we collect our things and head back home.

In years past when he required sedation during radiation we had to be there an hour before his scheduled radiation time and we wouldn't leave until perhaps 30 to 60 minutes afterwards depending on how long it would take him to wake up from sedation.  Now, we can be in and out in less than 30 minutes if everything goes smoothly, and that is amazing!  In addition, because they do the sedation patients early in the day, in years past we would be leaving the house at 6:30 AM and would sit in more than an hour of rush hour traffic on the way in.  Now, without sedation, we can schedule later in the day when traffic is light and that reduces the stress that much more.

Clayton never wants to be left out and he wants to come with us to radiation each day.  The boys both got a nice treat when the Boston Bruins came to the clinic last Wednesday.  The boys had a great time visiting with the hockey players who were all very nice.  Some of the players jumped right down on the floor to play with the kids.  Emmett enjoyed comparing scars with one of the players who had seen some action on the ice the night before (can you  guess which player it was?).  He agreed that Emmett's scars were by far the most impressive.

All said, things are going very well.  We're a week in to radiation, Emmett is feeling healthy and upbeat, and we're enjoying the monotony of a daily routine for once.  And Christmas is next week!

We appreciate the thoughtful cards and letters we've received from many of our friends back home in New Mexico and from friends and family around the country.  Your encouraging words bless and strengthen us -- thank you!  We wish you all Merry Christmas and hope you enjoy this special time of year when we remember and celebrate our Savior's birth.

One of Emmett's favorite pass times.

Emmett's toy from "Toy Friday" after his first week of radiation!  He loves it!

A good place

We got good news on Emmett's MRI results; everything looks stable.  They did mention that there's a lining near the tumor site that picked up a little contrast, but it's impossible to tell if it's because there's residual tumor there or whether it's the result of post-surgical change (scar tissue, etc.).  And that area is within the radiation field, so it will get treated either way.  We're happy about that.

We were glad that things looked stable and that there were no new areas of concern identified.  We also were glad that there were no questions raised about the area in his neck that got treated in Denver over the past year.  (We're always worried something might start happening there since he's not taking the EZH2 medicine anymore.)

All said, we're cleared to start radiation this week.  Emmett's first treatment will be Monday (moved up from Tuesday). 

With a full resection of Emmett's tumor, a clean MRI, and radiation and chemo starting this week, our family is in the best place possible, considering all the circumstances.  And for this we are very VERY thankful!  There is currently no disease that is posing a imminent threat to Emmett, and we're starting treatment from a clean baseline, and that's the best place we could possibly hope to be in.

Emmett is his happy old self again.  This week he has been obsessing over a toy trash truck that absolutely blew his mind when he saw it on Tuesday.  He's been talking non-stop about it all week and begging us to take him to buy it (with his own money).  We finally gave in yesterday, and he was very excited to bring it home.  He and Clayton have been playing with it constantly over the past day, and they're having so much fun.

Christmas is coming and everyone is getting excited.  And as far as we know, Emmett is healthy right now!  We feel like we've been given the gift of another Christmas where we will be in a good state mentally, where everyone is healthy, and we are hopeful about the future.  We have come to treasure these periods in our lives...and we pray that this one will last indefinitely.  We really do hope and pray that all the tumor is gone, and that the treatments will be effective.  Maybe another spot won't ever pop up again!  That's what we will continue to pray for!

The calm before the storm

Emmett's recovery from surgery has gone well.  The first week was pretty rough, he was rather discouraged by how different his body felt and how much pain he was in.  Feeling the stitches in his head was very strange.  He wouldn't open his mouth very much and didn't want us to make him smile or laugh.  Once he came off the post-op steroids his spirits brightened up significantly, and one week after surgery he was pretty much himself again.  And we were very glad to have him back!

Last Friday we had planning for radiation at Massachusetts General Hospital (MHG).  This involved a consultation with the radiation oncologist and a "mask making" session in conjunction with a CT scan.  The mask is to hold Emmett's head completely still while they administer the radiation to make sure that it goes to the right place.  They did a great job teaching Emmett was a radiation mask is for and they even made him his own mask that he could bring home.  Emmett did extremely well when they made his real mask and he actually seems a little excited for radiation.  In the past he did radiation sedated, but this time they think he can do it awake.  They suggest making him a playlist of his favorite music to listen to each day during his radiation sessions.  (He'll get radiation 5 days a week for 6 weeks, most likely).  I think Emmett is going to request some of the classic rock songs he's learned from some of his favorite Pixar and Dreamworks movies....I'm not sure how mom and dad feel about that. 

Clayton enjoyed the consultation with Dr. MacDonald perhaps even more than Emmett.  Clayton we've learned is very heterosexual and he gets so excited whenever there are new "gurls" around.  He was excited to ask Dr. MacDonald if she knew what bladders were and told her all about the pig's bladder that Laura and Mary played with like a balloon after Pa and Uncle Henry butchered the pig in the book "Little House in the Big Woods".  He then asked Dr. MacDonald if she was going to come with us in our car to Camp Sunshine up in Maine that night.  (What a way to warm up a girl before an invitation for a date!)

Camp Sunshine was a wonderful experience -- stay tuned for more on that.

Today we're back in the medical world and Emmett is getting his "post surgery, pre-radiation MRI".  We're praying that everything looks good to start his therapies as planned.  Radiation starts Monday and chemotherapy will be shortly after that.

The boys were excited to get a Christmas tree this past Monday and we even got a small tree to put in their room upstairs.  We are all excited for the Christmas, especially the boys!  The bad news is that Emmet wrote another letter to Santa yesterday and it was even bigger than the first...and I have a feeling that there will be more.

Clayton's 4th Birthday

Our other great adventure today was Clayton's birthday!  He was so excited to come down to the hospital to spend his birthday!  He was actually really sad last night when he had to go home: "Why does Emmett get to stay and have fun and I have to go home?" Katy took Clayton and Charlotte home last night so that she could make sure that Clayton's birthday today was especially special!

This morning Clayton was excited to wake up to birthday decorations!  And then on the way back to the hospital he got to pick out a dozen donuts.  Then when we got to the hospital he was surprised when the nurses brought him balloons and a birthday cake for his birthday!  "I can't wait to find out what flavor it is!" 

All afternoon he got to do his favorite hospital activities.  First we went to go search for "choo choo trains" -- the robots that bring the meal carts to each floor.  He and I stalked trains for the better part of an hour this afternoon.  Then he enjoyed doing some art projects and playing with toys in the family center.  And then he was a perfect gentleman on the elevator and held the door for everybody. 

He got to play some Wii with Emmett later this afternoon.  And then he enjoyed a visit from Grandma, Grandpa, and Aunt Laree.  His his final treat was getting to use the hospital shower which you can adjust for any height person!  (All day yesterday he couldn't stop talking about how cool the shower was and he was so excited to try it today for his birthday.)

On the way home from the hospital he and Emmett were completely wiped out...and they still both had the chocolate donuts remnants on their faces from this morning...which must be a sure sign of a great birthday.

Thanks to everyone who helped make this day for special for Clayton!

Brain Surgery

Emmett's brain surgery went really well on Monday!  Though it was a very stressful and emotional experience for all involved, it couldn't have gone any better.  The neurosurgeon says he got all the tumor out and all the doctors are all very happy with the result.  They were a little worried that the surgery might affect his speech and/or movement on the right side of his body, but he was talking and moving again right after surgery, and the neurosurgeon says that's a great sign.  By Tuesday evening he was cleared to get back on his feet, and before we knew it he was chasing a Star Wars drone around the hospital floor and I was having trouble keeping up.

He’s still recovering and it will take a few more days for him to gain all his strength back and for the dizziness to go away.  But it sounds like there should be no long-term side effects from the surgery.  And to us, that is nothing short of a miracle.

It honestly couldn't have gone any better.  It felt like life stopped when we left him in the OR.  I don't know that I will ever have words to express the thoughts, feelings, and emotions I experienced during the 5 hours he was in surgery.  To have him back now, and to have him still be the same old Emmett he's always been, is the best feeling in the world -- and nothing short of miraculous!

In the weeks ahead we’ll start radiation and then chemo.  But for now, we will enjoy a sweet respite between treatments.  And if all goes well, Emmett will be out of the hospital in time for Thanksgiving!  And what a thankful Thanksgiving it will be!

We appreciate all the emails, texts, and other messages of encouragement and support we received this week.  And we especially appreciate all those who were praying and/or fasting with us on Monday.  God is good -- and He answered your prayers!  Thank you all for thinking of our family.  May God bless you and yours!

We wish you a very happy Thanksgiving and hope you will take time to treasure the most important things in your life this holiday! 

 

 

Back in the saddle in Boston

After Emmett's October MRI and LP it took the doctors quite a while to finally come to us with their recommendation.  It was 3 three weeks before we got initial word from them, and four weeks before we finally were able to get on the phone with Dr. Chi.  And then the neurosurgeon she wanted us to talk to was out of the country until 11/13; so we arranged to travel to Boston and meet with him on that date.  Emmett had another MRI on 11/12 to give him a clear picture of where things stand.

Emmett's spot has grown by a factor of 2.5 since his early October MRI.  It's now measuring ~25 mm in diameter.  The neurosurgeon (Ed Smith) is still calling it small.  He reviewed the risks of surgery with us.  His opinion was to only do surgery if having it removed improves the prognosis; otherwise, just do radiation and other therapy.

There have been other discussions with doctors and a few ups and downs since we met with Dr. Smith on Tuesday, and maybe at some point I'll add those details, but for now let me just say that Emmett is scheduled surgery on Monday, 11/19.  Needless to say, we are anxious about this surgery.  This is the first time Emmett's had a surgery to remove tumor in his brain...in essence, this is Emmett's first true brain surgery.

We will be praying for Emmett and for his surgeon -- and for an overall blessing of divine protection and guidance as we move forward in faith.

LP Is Clear!!!

Emmett did great on his test on Monday and the results came back clear!  This is amazing, wonderful news!  Thank you all for your prayers and faith!

When the doctors identified a new spot of concern in last Friday in his MRI, he was automatically removed from the EZH2 trial that he's been on for the last year.  That medicine has been amazing for him and we're very grateful he had the opportunity to take it.  It shrank and controlled the spot in his neck on the front of his spinal cord which doctors wouldn't radiate or remove surgically because of the risks involved -- so it was a miracle and a blessing that this experimental medicine treated that spot.  We hoped it was providing therapeutic, systemic treatment to his entire body, but apparently this new spot in his brain was impervious to the medicine.  Thankfully it looks like we'll have other treatment options for this spot...it looks like it may be a candidate for radiation or surgery.  The doctors are conferencing this week and we expect to hear something from them in the next few days.

In the meantime, we are enjoying some wonderful family time together.  Emmett is especially excited that he doesn't have to take the "gross, disgusting medicine" anymore!  We are all very excited for him in that regard.

We pray that the spot in his neck was completely treated by the EZH2 medicine and doesn't come back now that he's off it.

We imagine that after treating this new spot, the doctors will likely recommend more systemic treatment (traditional chemotherapy or something else new and experimental).

Each day with loved ones is a miracle....and we continue being blessed with many, many miracles.  And we continue praying for many more.  

Thank you all for your love, support, and faith!

Prayers please!

We got some unsettling news this week and we have a follow up test on Monday to help gain more information. As such, please keep Emmett and our family in your prayers.  Pray that Emmett's Lumbar Puncture (LP) test comes back clear and that the Lord leads us to the best path forward.

Hugs!

Emmett's getting baptized!!

This is a very exciting day for our family and especially for Emmett!  We are so proud of him making the decision to be baptized and for everything he has done to prepare for this big day.

When Emmett was in treatment back in 2012 this day seemed so far away...and at times I wondered if it would ever arrive.  And now here are, 6 years later!  And he's doing great!  He's still on the phase 1 clinical trial, but he continues to tolerate the medicine very well and the spot that showed up last summer went away and hasn't come back, and that's a miracle!

We feel so blessed and thankful for the blessings of heaven we have received over the years.  We are especially grateful for the prayers, faith, and love of the many people who have ministered to us!  Often we've felt the love of our Savior through you!

We are so excited Emmett's baptismal day has arrived -- it will be celebrated on many different levels!

May MRI Results

Emmett had his next MRI today and the results confirmed that his spot has reduced at least 25% since starting the trial...and now that he's had two scans in a row that show a reduction of at least 25%, Emmett was officially declared a partial response today!  This exciting development is a follow up to our 5/7 post and we were very thrilled that "official partial response" is the word we got today.  So YAY for good news!  We'll take whatever we can get.

The team also had us sign new consent forms today which were updated with the information about this girl on the trial who came down with lymphoma.  The team didn't really have any new information to share about this case, the FDA hasn't released any conclusions yet from their investigation...so for now we're in a holding pattern.  We again decided to continue the trial at Emmett's current dose, and we will probably continue at this dose until more information becomes available.  It's no surprise, but oncologists generally want to hit with everything they've got...and so that's what we're going to do for now.  We did reach out to Emmett's primary oncology team in Boston to get their input on what we should do, and we were really hoping for some thoughtful guidance, but we never heard back. Ugh.

So that's where things stand today.  Thanks for keeping Emmett in your prayers!  We hope to keep finding more good news to share!

A few inspiring verses from my Old Testament study today when Joshua was preparing to lead the Israelites into the promised land:

"Have not I commanded thee? Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee whithersoever thou goest" (Joshua 1:9).

"Sanctify yourselves: for to morrow the Lord will do wonders among you" (Joshua 3:5).

May we ever be courageous and worthy of the Lord's blessings!

The best part of the weekend for the boys was the Fathers and Sons camp out.  In order to get back in time we moved Emmett's MRI to Thursday and rented a minivan for the drive north, then we dumped it at the airport and flew back Friday afternoon after our morning clinic appointments.  They loved camping out -- and playing with laser guns and exploring the great outdoors with the Cook boys.  Clayton did fight sleep, however ;)

A Glorious Decade

Celebrating 10 years with the love of my life today!

Info from Dr. Hoffman

We met with Dr. Hoffman on Monday and gathered as much information as she had to offer about the girl who came down with lymphoma and the options for Emmett moving forward.  I know the specific details she shared won't mean much to the casual reader, but because our blog provides us with a concise, searchable medical history for future reference, I'll add most of what she shared below.

• The girl who came down with lymphoma had a different primary tumor type than Emmett (epithelioid sarcoma).  Her treatment history (and associated risk factors from her prior treatments) is still under investigation.  The drug company and the FDA want to gather and study all the available details of her medical history before determining what any impacts may be on the study moving forward.  Dr. Hoffman doesn't think this will cause the FDA to close the study, but perhaps they'll cap the total drug dose a patient can receive or limit the number of months a patient can be on the study.  But it's really too early to tell at this point.
• A secondary lymphoma is generally not a risk factor for most treatment protocols -- leukemia, on the other hand, is rather common.
• Radiation may increase the risk for a secondary lymphoma, and Dr. Hoffman believes this patient had received some radiation; however, lymphoma is still a rare side effect for irradiated patients.
• In laboratory studies, Emmett's EZH2 medicine did cause a secondary lymphoma is rats in very high dose levels (orders of magnitude higher than what humans receive).  This leads the doctors to think that this girl's lymphoma is likely caused by Emmett's medicine.
• The girl was on a lower dose (900 mg/m^2) than Emmett (1200 mg/m^2)
• She had been on the study much longer than Emmett when she came down with lymphoma -- 19 cycles is what Dr. Hoffman recalled, and each cycle is 4 weeks.  So that means she had been on the drug 76 weeks and Emmett has been on the drug ~40 weeks.
• In terms of total dose, Emmett has received ~50% of what the girl had received when she came down with lymphoma.  Perhaps this means that we have a little time before things get critical for Emmett.
• A particular patient may be genetically pre-disposed (i.e. more likely) to develop lymphoma upon exposure to a new drug than another (i.e. this girl's unique DNA may make her more susceptible to developing lymphoma than Emmett would be)
• 700 total patient have received the drug, and only 1 lymphoma case has been reported.  The 700 patients includes mostly adults -- only about 25 pediatric patients have taken the drug.  About 12-15 patients are further along on the clinical trial than Emmett is.
• Pediatrics receive a higher dose of the EZH2 medicine than adults because kids metabolize drugs differently and generally can tolerate much higher levels than adults.  Especially for kids with central nervous system tumors, you want the dose to be as high as can be tolerated to help it cross the blood brain barrier.  The adult dose is 800 mg/m^2.
• Non-Hodgkins lymphomas -- the type this drug can cause -- are generally treatable with success, though they do require a traditional chemotherapy protocol that is relatively tough on patients (and ~9 months long).  In Emmett's case, however, he's already had one of the main drugs that would be used to treat a non-Hodkins lymphoma (doxorubicin).  This drug has a total-dose cap due to potential organ damage (heart).  Dr. Hoffman was going to look into how much more doxorubicin Emmett can handle and also the treatment options for NHL without using doxorubicin (and their expected effectiveness).  We hope to hear more soon.
• The FDA and the drug company are currently agreeable to having patients (1) continue therapy at their current dose, (2) continue therapy at a reduced dose, (3) pausing therapy with the option to restart later after more information is available, (4) ceasing therapy completely (an option at any point).  These options may change at any time pending their investigations.
• If the FDA was extremely concerned, they would put an across-the-board hold on the clinical trial.  The fact that they haven't done this is good sign...for now.

After a thoughtful weekend of fasting and prayer, and after considering Dr. Hoffman's information, we decided to continue the trial at Emmett's current dose for at least two more weeks until next next MRI.  This will give the FDA/drug company (and other) doctors a chance to review all the available information and put together their recommendation.  We're also hoping to get some input from Dr. Chi in the meantime.

We know that the drug in its current form has helped Emmett significantly, and we think it's prudent to get him at least two more weeks on the medicine when weighing the risks against the benefits it's provided him.  Hopefully by the time we go back to Denver we'll have a more complete picture from the doctors that will allow us to clearly discern what our next move should be.

Some good news....and then a twist

The message we've received from the doctors on the size of Emmett's tumor since starting this clinical trial last August has always been consistent: after initially shrinking ~25% in the first two months, the spot has remained stable.  When Emmett had his March MRI we heard the same thing -- the spot was still approximately the same size as it's been since October.  However, when we met with the doctors two weeks later the message had changed.  At our early April clinic appointment they said that upon closer review the team had concluded that Emmett's spot has still been slowly shrinking, and now it was officially small enough to officially re-classify Emmett as a "partial response" to this medicine.  (In order to officially re-classify a patient they require two MRIs that both indicate at least a 25% reduction that are at least 8 weeks apart, so Emmett won't officially be reclassified until after his May MRI, assuming his spot hasn't gotten any larger.)

We were very excited to hear that Emmett's spot has continued to shrink!  Another miracle to add to our list!

We hadn't realized the detailed requirements for a "partial response" classification -- we thought he was already considered a partial response.  But we're not too concerned about the semantics -- news that the spot is continuing to shrink, albeit slowly, is welcome news indeed!

And then just this week we got an unexpected phone call from Dr. Hoffman.  She wanted to let us know that one of the kids on Emmett's trial was just diagnosed with a secondary cancer: lymphoma.  It's possible that the lymphoma is a side effect of their initial cancer treatment protocol.  It's also possible that the medicine that Emmett's on caused the lymphoma.  Unfortunately it's impossible to know conclusively given the very little available data, and that's the whole purpose of a clinical trial -- to measure treatment effectiveness and to monitor side effects. 

And so here we are today -- with a medicine that is continuing to benefit Emmett, but that may give him another cancer (or worse).

Our next meeting with the medical team is on Monday.  They're going to gather as much available data to share with us at that time, and then we'll decide on our path forward.  Possible options include:

1.  Continue the trial at Emmett's current dose.
2.  Continue the trial at a reduced dose.
3.  Discontinue the trial (and perhaps consider other therapies).

Some of the questions I have for the medical team are:

• What dose of Emmett's medicine was this patient on?
• How long had the patient been on the trial?
• What primary cancer did the patient have?
• What treatments did the patient have for the primary cancer?
• What were the risk factors for the above treatments?  Was there an increased risk factor for a secondary lymphoma given the initial treatments?
• How many total kids have been on Emmett's clinical trial?  How many of them have been on the trial longer than Emmett?  And at what dose?
• Based upon the data available today, and assuming that this patient's lymphoma was caused by Emmett's medicine, what's the percentage chance of getting lymphoma?  And at what length of time on the trial?
• What are the treatment options for a secondary lymphoma given the therapies Emmett has already had?  And how effective might they be?
• Would a PET/CT or other imaging study help reveal whether there's still active tumor that needs further treatment?
• If we discontinue the trial, would Emmett be able to get more of this medicine if his tumor starts coming back?
• If we discontinue the trial, would the recommendation be "watch and wait", or would the doctors want us to consider another trial?  If so, what?

As Dr. Chi has discussed with us many times, when a child has a malignancy that is threatening their well being, that malignancy presents the most immediate danger to the child, and doctors generally want to focus primarily on treating that condition rather than holding off therapy because of the other conditions that the treatment might cause.  And in Emmett's case, we know that this therapy is effective against his greatest risk.  So there's a part of you that doesn't want to stop the full frontal assault.  At the same time, the thought that the medicine you're giving your child each day may give him another cancer really shakes you to the core.

And so here we are again, with big decisions, and very limited data, and Emmett's health and well being in the balance.

As always, we will make this a matter of fasting and prayer.  We've been led and inspired by divine power in the past, and I'm confident that the Lord will walk with us again this time.  I'm thankful for an opportunity to fast and pray this weekend for divine guidance, and we would welcome any and all to join us. 

Thank you all for your prayers and faith!

January 2018 MRI

Today Emmett had his third MRI since starting the clinical trial at Children's Hospital Colorado.  The scan showed that everything has remained stable since his last scan -- yay!  Emmett has now had three scans since starting the clinical trial.  The first scan in October showed a significant reduction in Emmett's tumor, and the second and third both showed stability, and that is amazing news.

While we've hoped to hear of continued reductions of this spot, it's important to remember that Emmett has always had scar tissue in this area since his last spinal surgery in 2012.  A few times over the years the doctors have wondered whether this area might contain active tissue, but it's never showed activity until June 2017, and so they've never been concerned about it until then.  Given that he's had scar tissue here for the better part of six years, it's understandable that it may not respond completely (i.e. reduce down to zero) because it wasn't zero to begin with.

In looking at the imaging myself, what remains in this spot looks about the same size as what it was in January 2017 when the doctors had no concerns.  Perhaps it's slightly larger now, or changed in shape slightly -- but overall it's roughly the same size as when the doctors were not concerned.  So maybe he's close to his "non-zero" baseline.

Upon reviewing the MRI results with our doctor she mentioned that sometimes tumors reduce significantly upon treatment but never completely go away, even though they are shown to be clinically "dead" upon subsequent biopsy.  Without a biopsy it's impossible to prove whether residual tissue is benign, and in Emmett's case there's too much risk to do a biopsy, so we'll never know for sure.  But we can hope and pray that this is the case.

Our doctor did mention that spots that pick up contrast in MRIs are more likely to be vascular (which scar tissue generally is not), so that fact that Emmett's spot lights up on an MRI may be a bad omen.  But then again, with each additional surgery / treatment / intervention, the less the traditional rules may apply...so we'll take that for what it's worth.

What we will take (and are extremely excited about) are two more months of life the way we're currently living it -- trips to Denver every other weekend to get more medicine, but otherwise home in Albuquerque living as close to a "normal family life" as possible.  The thought of another two months of this routine is very exciting!!! 

We feel so blessed and thankful to be where we are today and we're praying that this period of our lives may continue.  How thankful we are for everyone who continues to remember Emmett and our family in your prayers.  The miracles keep coming, and each of you play a part in that!

Welcome 2018

We have thoroughly enjoyed the last few months since Emmett's good news MRI in October.  The blessings of the past few months have been remarkable indeed.

After Emmett's October scan, we were thrilled by the realization that we would get to spend Halloween in Albuquerque together as a family.  It's been a long time since we've had the opportunity to do that.  We were likewise excited that we would get to celebrate Thanksgiving before Emmett's next MRI.  That was also another great blessing.  Over these past months we've also been blessed by several visits from family who made the trek out to New Mexico, and those have made for sweet memories.  And we've also been able to drive a "few" extra miles on our trips to Denver to enjoy family time in Fort Collins and Salt Lake City.  And those were wonderful times.

And to say that we enjoyed spending Christmas at home in ABQ is the world's greatest understatement.  The week off between Christmas and New Year's made for very treasured family time.

Overall, we just continue to feel so blessed and Thankful.

Emmett had another MRI on 11/30/17, and that scan showed stability from the October scan.  The spot still hasn't reduced completely, and the doctors are certainly still concerned about it, but we are very, very happy that it hadn't grow at all from early October to late November.  And our oncologist thought that it may have reduced 1mm in one dimension, and we will take whatever encouragement we can get.

We keep praying for further reduction and hope this medicine will continue working its magic!  Or at least keep this spot from growing!  As long as it doesn't grow more than 20% we can continue on this study.

Emmett's next MRI is a few weeks from now and we're praying for good news.  In the meantime, we'll continue watching two boys smother their new little sister with an overabundance of love and affection.