Ciara was in Crumlin on Monday for her MRI on Tuesday. By Tuesday lunchtime, Ciara had been fasting since 9pm the previous night and, as you can imagine, was very hungry. We managed to distract her with lots of playroom fun though. While I was working in her room Dr Breaneach came in with a bunch of new doctors and wasn't his normal cheery self. He sat on the bed and told me that the bone marrow aspirates taken the previous Friday showed cause for concern. I asked him to wait for me to get Yvonne before he carried on.
To recap, the last results showed that her marrow was clear of neuroblastoma. However this results showed 40% neuroblastoma cells. Dr Breanach said that neuroblastoma is very patchy, as a result, the last aspirates could have just missed everything and come up clear. So from this it would be difficult to tell the progress, if we'd missed all the cancer last time, we wouldn't know if this one was less than before. There was also a chance that the cancer had come back between the previous and recent aspirates. He ordered a urine catechlomines test which would give a biological view as to what was happening. We managed to get Ciara to wee on demand and this was sent off to the lab.
Ciara was shortly sent up for the MRI where she reluctantly had another general anaesthetic. We went off for lunch and to chew our nails, waiting for the worst from the urine test but of course hoping for the best.
Five traumatic hours later, the results of the urine test came back. A normal level of catechlomines is 14. When Ciara was first diagnosed her level was 150. A test a couple of months ago, after chemo, was 70. Tuesday's results were 20 something, nearly normal! So why the positive results to the bone marrow aspirates? The biology didn't match the morphology. Dr Breanach asked himself this question and pulled up the results of the previous aspirates. The comments said that there were "40% abnormal cells". Chemo damages bone marrow cells, and so does cancer. In the first aspirates, abnormal was interpreted as cells damaged by chemo, not cancer.
Once Ciara had recovered from the GA, we were sent home. There was a brief delay in getting home as some idiot had left the lights on in the car and the battery was flat. The same idiot was even told the day before that his lights were on, he checked the car still started then forgot to turn the lights off!
We still needed to wait for the result of the trephines (a bone core) taken from last Friday. And of course we needed to wait for the results of Tuesday's MRI. Both of these would come back Thursday, today.
Today was very anxious. I worked from home but found it difficult to concentrate. By 5pm would couldn't wait any longer and chased up the hospital. A call came back a few minutes later.
The MRI showed excellent progress and the trephines came back clear, no neuroblastoma. So it's looking more like the recent aspirate tests were miss-interpreted as neuroblastoma rather than chemo-damaged cells. The haemotologist did say to Dr Breanach that it's very difficult to tell the difference between neuroblastoma cells and chemo damaged cells. Another new test will be carried out to try and clear up the confusion with the results due maybe Friday. In the mean time, Ciara will wait for her blood count to come back up before the next TVD (chemo session). If they come up early enough she may be OK to go ahead with the stem cell harvesting before the next TVD. Surgery is to be held off until further notice, but we expected that.
For the last three days Ciara has been radioactive and Yvonne has been away. Ciara and I were up on Wednesday for the dye injection then back up yesterday for the scan itself. The time between Ciara going under general anaesthetic and coming out of the recovery room were extremely lonely and I would not recommend doing it alone to anyone. It was great to have Ciara back with me though.
