Update on the leg and chemo

Brent's pathology reports came back!! Drum roll please..... all the margins are clear. That means the doctors cut far enough from the edges of the cancer to get all of it without leaving any behind. AND... the cancer was 90% dead!!! Dr. Beinart was shooting for 99% but this is still a a great result. Since there was still 10% alive (even though technically it is really all gone since they took the leg), Brent is continuing with the chemo. He will have 4 in-patient treatments every 3 weeks lasting about 5 days that will consist of getting 7 doses of Ifex and then 4 rounds of out-patient treatments of a completely different chemo med. Our friend Britne who just finished her chemo says the out-patients are a piece of cake. We are hoping that all the chemo will be done around November!!

Britt finished chemo on June 12th!!!! Her END-OF-CHEMO party at Dr. B's office.

Brent's leg(residual limb) is healing very well. He had about half of the stitches taken out at the end of May and the rest 2 weeks later in June (about 20 stitches all together). There is a place located where the back of his knee would be that is having some problems. The skin has folded in and is pretty deep. It isn't painful and doesn't cause him any problems, but the doctors are worried about it from a hygeniene point. In July, Brent will go see a plastic surgeon for a consult to see what can be done about it. Most likely, they will wait until all the chemo is finished to fix it. The swelling has gone down very quickly. Brent was given a compression sock after the surgery that is very tight and worn on the limb to help reduce swelling. He recently had to get a smaller sock since the swelling had decreased so much. Mentally, he's been doing pretty well. He has his good and bad days, but who can blame him. He's slowly becoming more use to it. Also, the phantom sensations were pretty bad the first month. Nuerontin was prescribed for it, but didn't really help alot.

Brent's swimming!!!



Brent started his first round of post-op chemo on June 5th. He was in the hospital from Friday to Wednesday. Everything went as planned. The two biggest complaints were A. he got a dose of steroids at 9 p.m. so he was up all night. I was miserable and not to mention, very cranky. and B. everytime he stood up, he got the hiccups, which can also be an effect of the steroids. Brent felt pretty good the rest of the week, but on Sunday he got the dreaded fever. I was very resistant in calling the doctor. He had been feeling so well and had a good amount of energy so I assumed his counts had just dropped a little and thought we could ride it out. Well good thing Brent called on his own. The doctor on call sent us to the emergency room to be admitted immediately. The bloodwork results showed that he was nuetropenic to say the least. Brent was going to be staying at the hospital for a few days. After a few bags of blood and 2 units of platelets, his counts were high enough for us to go home. Also, Dr. Beinart prescribed Lyrica for the phantom sensations and it has helped alot!

The hair is falling out again. This time we decided to take a different approach.

Yes... that is duck tape.

In between the first post-op round and the next, Brent got casted for his prosthesis!!!! We are so excited for him to get a leg!!! Can't wait. Brent hates his crutches. At the first appointment, they fit him with a liner and took a few measurements. He will wear this liner inside his socket. The liner is made of silicone and has "ribs" on the outside. These ribs help create a vacuum/suction inside the socket to hold the prosthesis to the limb.
We call the liner, the Space Suit. The white area is the ribs.
Next, they did the casting. The mold was made out of plaster and the whole process was very interesting.

A few days later, we had a test run. Brent was fitted into the test socket, and more measurements were taken. They are going to make a few adjustments and then we will go back for another test run.
It's a bit hard to see the socket because it is clear. It's over the space suit. That's Scott Spring, Brent's prothetist, on the side. He is really good at what he does and seems to really care about his patients. We think he is awesome!

Once the socket is ready, Scott will make all the arrangements for the components of the leg to come in, and piece them together. Hopefully it will only take a few more weeks!!

Brent is finishing up round 2 of post-op chemo right now. He started Friday, June 26 and hasn't complained too much. Dr. Beinart lowered the dose because Brent's counts dropped so low last time, so we are in here for 1 less day!! He has been sleeping alot this round, and thankfully not keeping me up all night. Still getting the hiccups.
I'm getting pretty burnt out on the hospital stays lately. I have actually snuck away quite a bit this round! Went to Cafe Adobe with my mom and stepdad on Saturday.

more...

Mini Vacation
Before Brent's surgery, Mandy and Nick flew down and the whole family got to go to New Braunfels. We had so much fun!!
Eric and Nick with the Potato Gun

Paul getting the tubes ready to float the river

All of us at the Grist Mill-YUM!!

After a few days in New Braunfels, we decided to drive up to Grandma and Grandpa Cassell's in Marble Falls to visit and play golf.



Brent had surgery
Well I know this update is late, and mostly everyone already knows Brent had his surgery but I still needed to post about it. Brent's surgery was on Friday, May 8th. He was originally scheduled to come in at 7 am for surgery at 9 am but when Brent called on Thursday to confirm, they told him it was moved to 3 pm and we needed to be there by 1 p.m. So Friday morning we slept in, and were slowing gathering our things, when the hospital called and said the time was wrong and we had to come right away (which was around 10:30 am). Talk about stress overload! Brent wasn't mentally prepared to be going in so early. We loaded everything up, said our goodbyes and headed out.
Saying goodbye :(

It was a really hard day. On the way, Brent had a few breakdowns. How can you be willing to tell someone to cut off your leg? When we got to the hospital, Brent was taken back to the pre-op area and I wasn't allowed to come, but once the nurse saw the heartache Brent was going through, she snuck me in. After a few more breakdowns, Brent was taken back so that he could have two nerve blocks put in his leg, one in the back nerve (sciatic) and one in the front (femoral). This was done for pain management after the surgery. Once they were done with this, they took him up to surgery and then a few hours later, he was done! Dr. Marco and Dr. Jones said he did very well in surgery. When he started waking up, the nurse came and got me. He kept asking if it was really gone. New part of our life-Phantom Sensations. Brent could still feel his leg.
It was a LONG day!


Besides all that happened that day, we actually had a FUN time at the hospital. We had quite a few visitors and we're almost kicked out for being too loud. Nick brought the Wii up and we had a blast.
My mom playing soccer.
David hula hooping.

Bridget’s Wedding
One of my most wonderful friends from high school, Bridget got married on May 16th. I am so happy for her! She was a beautiful bride and her wedding was gorgeous!

The New Mr. and Mrs. Derek Dupree!!

Ivy's Bday
Ivy (my cousin) turned 7 this year! She’s getting so big!!


Whit went to her last Prom
Isn't she GORGEOUS?


Memorial Weekend


Graduations
Do we have a doctor in the house? Why YES we do! Laura graduated from med school at UT Southwestern Thursday, June 4th. She will be starting her residency at UT Southwestern in anesthesiology in July.

Whitney graduated from Clements high school June 5th (the day after Laura's...it was a long night). She headed up to Utah Valley University last week.




Baby Fever
We (well not us but our friends) have a few new additions!!

Rylan Patrick Simmons was born on January 25th to our fun friends Jennika and Brodie

Laci May Nielsen was born on April 21 to proud parents Rob and Jessica

My amazing sister gave birth to Colton Mathew Locke on June 2 with help from her wonderful fiance Jimmy.

AND, drum roll please.... Laura is due in November with a boy!!!!

Since we’ve been gone….

A lot has happened since we posted last, so lets get everyone up to speed.

Round 4: February 20-24
Everything went well except he got a fever.... again. Had to go back into the hospital March 4th for a blood transfusion.

Check out Brent's nails.


Houston Livestock Show and Rodeo
This year I got to go to the Cookoff with my friend Jessica Johnson.

I also went to see Clay Walker with her.

Laura came to town and we (including Brent!!) went to see Brad Paisley the night before his 5th round started.

Round 5: March 13-17
We’ve been so blessed to have Laura around so much lately. She kept us all entertained up at the hospital. Brent was assigned a double room but they didn’t put anyone else in there, so we had tons of room….and I got my own bed!!

New Friends

This is our new friend Brittne. Brittne is 20 years old, has Ewing’s Sarcoma and was in the hospital at the same time as Brent. Her doctors are Dr. Marco and Dr. Beinart also. Last November, Brittne had a very large tumor removed from her spine and had 3 vertebrae replaced. She will be finishing up the rest of her outpatient treatments in the middle of June or July. Her last scans showed NED (No Evidence of Disease). A BIG Congratulations goes out to her!!

We have another new friend. Chris is around the same age as Brent and was in the hospital most days that Brent was there. Chris is fighting through his 5th type of cancer. He’s a fighter and will get through this. He is finishing up the last of his treatments this month.

Please pray for our new friends as they continue on their journeys!!

Tea Party April 15
My mom and I were on a Tea Party committee! It was so much fun and really awesome to feel like you re a part of something. Aunt Pammy-How did we miss you?


My cousin is Miss Rodeo Austin and she spoke at the Tea Party. Isn’t she gorgeous?? Boys back off-she’s only 16. Courtney will be competing for Miss Rodeo Texas later this month.

Rockets Game
We went to the 5th game of the first round of the playoffs for the rockets. It was so much fun and the rockets won!! Too bad they couldn’t beat the Lakers! Maybe next year.

Big Decisions Ahead

Brent is doing very well. He had his fourth treatment from February 20-24. On the 20th, he had an MRI to see the change in the tumor. His doc said that the tumor has shrank quite a bit; probably from the size of a small orange to a key lime. The one area of concern is that the cancer affected part of the tibia and part of the fibula, and the tissue where the tumor was is now dead. The nerve/foot drop is also a problem. So there are only 2 options for Brent’s surgery.

A.) A total knee replacement including taking out part of the tibia and fibula with a skin graph from his upper thigh, and a nerve graph from his other leg for the foot drop.

B.) Above-the-knee amputation.

I think that the amputation is the most logical choice and probably the choice Brent will go with. With the amputation, the chance of the cancer coming back in the same area is 5% compared to the knee replacement which is 15%. This is a HUGE difference when it comes to cancer. Also, with the knee replacement he will have scars all around his knee, then on his thigh where they do the skin graph, and also where they take the one nerve out and then another where they put it in. As for the foot drop, the nerve graph only has a 10% chance of working, so Brent would be more functional with a prosthetic. We went to the prosthetic company and looked at what they have to offer. It was funny because Brent actually thought it was cool looking at the different types of knees and legs. Of course his engineering side came out and he wanted to know everything about them. I think we are going to talk to the surgeon one last time to make sure we have all the facts straight.

Third Times a Charm!

Treatment #3: January 30-February 3
I LOVE Brent’s doctor!! Since round 2 was so horrible, he lowered the doses for the chemo meds. It has made a HUGE difference. We had little scare a week after his treatment when the doctor called and said he thought Brent’s counts were too low and that he might need another blood transfusion. So we headed back to the hospital to have more blood drawn to see where his counts were. Luckily, it turned out that they had gone up so we got to go home without a blood transfusion. Brent has had so much more energy; he even took me to Cheesecake Factory on the Thursday before Valentine’s Day… DELICIOUS!! Our lives felt a bit normal for a whole evening. Laura and Erik came into town for Valentine’s weekend. We love having them here and wish we could see them more. We all goofed off shooting BB guns Saturday and then had a “romantic” Valentine’s dinner at Sweet Mesquite. The week before Brent went in for his 4th treatment, he was able to go to work for a few hours each day and was doing really well.



Laura and Erik got a new puppy. His name is Hurley and he is ADORABLE! Natalie and Robby loved playing with him.

The Other Cancer

In the midst of Brent's terrible #2 treatment, I had minor surgery (well...I wouldn’t call it surgery) to remove more abnormal moles. I had three spots cut out of my left foot. Luckily, the reports came back as abnormal and not melanoma again. The best part about it was that I was awake during the procedure. The dr was going to sedate me, but I forgot I wasn’t supposed to eat after midnight the night before. I woke up that morning, started eating my toast and halfway through it, I remembered. Brent started yelling at me “Spit it out, Spit it out!” At the hospital, I was referred to as “the girl who ate toast”; they didn’t know what to do with me. After quite a bit of embarrassment, the anesthesiologist decided they would just numb my leg. It was so neat being awake during the procedure because I got to talk to the nurses and dr the whole time and he let me sit up and watch part of it.




The Pathetic Patients

Terrible Two

Brent’s second round started on Jan 9th. This round didn’t go as well as the last one. One problem was that we didn’t get to the hospital until around 2, so by the time they got Brent admitted and the meds were mixed it was around 10:00 at night. Another problem was that since Brent has so many different fluids being pumping into him, he has to go to the bathroom A LOT; so he decided that this round he wasn’t going to drink as much water. BIG MISTAKE!! The number one rule while going through chemo is to drink, drink, drink because it helps flush out all the meds, and he can start feeling well sooner. By Sunday, Brent was completely wiped out.


the beginning


the end

Tuesday he was released and got to come home, and we were greeted by this wonderful sign our friends' cute kids made. We love you guys!! Thank you to Robby, LuLu (Natalie), Mark, Elia,and Lauren (and Jess!!).



That night Brent started getting nauseated. He threw up once in the middle of the night and again when we woke up the next morning (Wednesday). We headed to the hospital for his Neulasta shot and when we got to the hospital, he threw up again. The nurses called the doctor and 10 minutes later, Brent was readmitted. They decided they would keep him for a few hours to give him Zofran and Decadron for the nausea, and fluids since he wasn’t keeping anything down. He was released the same day and was feeling much better when we got home. Everything after that was going pretty well until the next Sunday (January 18th) when Brent got a fever. We called the dr. and were told to give him Tylenol to keep the fever down until the office was open in the morning. Monday we headed up to the Medical Center and Brent was admitted once again. Brent’s counts were extremely low. His white blood count was 0.18; normal is between 5-10. I don’t remember what his reds and platelets were, but they were really low too. The doctors tested him for all kinds of infection, but didn’t find any. This means that most likely his fever was just because his white counts were so low. They also gave him blood and platelet transfusions!






Platelets

Brent felt so much better after all was done, and we had a nice last week before he went in for the next treatment.