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Madison Smith's Website - Viewing Journal - Monday, June 9, 2008 6:17 PM
Thank you for taking time to inquire about Madison and how she is doing. Madison was diagnosed with high risk T-cell Acute Leukemia Lymphoma on September 24, 2003 at Duke Hospital in North Carolina. She had just turned three at that time. Leukemia is a blood cancer that is not believed by medical professionals to be inherited at this time. She presented with a mass in her chest that encompassed the majority of the upper half of her chest area. The mass was related to the leukemia. It collapsed her left lung and a portion of her right lung and was shutting off the blood flow from her heart to the rest of her body. She was in the pediatric intensive care unit for almost two weeks on a ventilator. We weren't sure then if we would ever have a chance to fight the leukemia. Madi is a true fighter and pulled through! After getting off the vent, Madison was able to achieve remission by the 28th day of treatment. She underwent two and half years of aggressive chemotherapy (protocol 1961) and radiation for the mass. On Christmas Eve 2005, a little over two years after her diagnosis Madison had a chest CT done that revealed that the mass was finally gone! Madison finished her treatment in January 2006. Children that have cancer are not considered "cured" until they have been off treatment with no-reoccurrence for five years. Duke has followed Madison throughout her treatment. She will continue to be followed by Duke. In April 2008 Duke uncovered that Madison has an obstruction in 3 of her veins. The veins involved are the Left innominate vein, the left (lower) internal jugular vein, and her sub-clavian vein. These veins are responsible for carrying her blood back to her heart and hers are 100% occluded. What is going on with her right now is likely a result of the mass she had in 2003. There aren't really any easy fixes for what is going on with her and no real cases that it can be compared to. We are working with Duke in an effort to resolve this issue. We've come this far for a reason and we will get through this new hurdle. Please continue to lift all of us up. The care and concern that we have felt from all of you continues to be an encouragement to us. Thank you...
 
- Allison

Update - Monday, June 9, 2008 6:17 PM


June 09, 2008 11:45pm

I have a special & important message to get out in reference to the 2008 Man & Woman of the Year Campaign! With all of your help, The Leukemia & Lymphoma Society reached their goal of raising the millioneth dollar since the campaign’s inception. Special congratulations go out to Dr. Mark Yofee and Robin Smith for winning the official title for 2008. It was my honor to be one of twelve candidates that had a hand in raising more than $329,000 in only eight weeks for The Leukemia & Lymphoma Society! Thank you to all of you for giving to this awesome cause!

A special thank you goes out to Plainview Elementary School, Bethesda Friends Meeting, & Foresters for organizing events/campaigns that generated just about half of the total money my campaign raised, which at last count was $21,400! I also need to thank all of the businesses that graciously donated auction items for the final auction. Those auction items generated an additional $2400.00 for The Society that would not have been possible without you. Specifically, Arts of Love,The Beaufort House Bed & Breakfast, The Blue Water Spa,Beasley Contracting,The Carolina Hurricane’s, Duke & Coach K, Prismaflex , Just Claying Around, Skin Sense A Day Spa. Thank you to the Dunn Daily Record and Sampson Independent for running front page articles. Thank you to NBC 17 and Kim Genardo for being such an awesome host to Mrs. Shannon Best and Mrs. Allison Godwin’s classes from Plainview Elementary! Thank you to the students in those classes, you really earned that trip! I hope it was fun! You guys have now had your 30 seconds of fame with your Wake Up call that aired on Friday.

Today was officially the last day of school for Madi. I took Madi in for a few minutes this morning to get her report card and to tell her friends bye. Madison will miss her teacher dearly but is definitely ready for summer break.

Madison had a pretty good weekend this weekend. By Sunday though I think she had probably over done it and didn’t feel very good most of the day. Today has been much better. She actually went to spend the night with a friend tonight and they haven’t called me to come get her, so that’s a win! She went to Bible School tonight with her friend Hannah and she said she had a great time. When I spoke to her on the phone, she really sounded like she felt pretty good.

Since last update I’ve had opportunity to do some more reading in reference to Mediastinal Masses in pediatric cancer patients. From this reading, I now have it in my mind that there are probably other pediatric cancer patients that had a mass in their chest for which other complications such as obstructions arose. I have to believe there is someone else out there that has or is going through what we are with Madi. I plan to research pediatric Hem/Onc doctors that have especially dealt with Mediastinal Masses like what Madison had when she was diagnosed. If there is someone to be found that may shed some additional light on all of this, I want to find them! We believe that all of Madi’s obstructions/occlusions were caused by her mass back in 2003. Really only peds Hem/onc will be well versed in the masses and only peds cardiology would be well versed in obstructions/ occlusions. Who knows where this will go. If you know someone else that might be well versed in either of those arena’s or someone that could point me to someone else that has experience with this, please let me know. It never hurts to ask. I will continue to read....

Thank you for all of your support! Please keep us in your prayers.

Friday June 6, 2008 1:10pm

Madison came home last night and had a pretty good night. She seems to feel pretty good for the exception of some tenderness at the cath sites. We had breakfast out this morning but she is just going to relax at home today. Last night she developed red puffy rings around both of her eyes. I gave her some Benedryl and it had improved some by this morning. I recently learned from Duke that they had put some gel and tape around her eyes when they sedated her and that her puffy eyes should not be a concern.

We've had some time to think about the events of yesterday and I will attempt to share some of our thoughts. Although yesterday we had hoped things would turn out differently than they did, today, we have a lot to be thankful for! First, Madison is not any worse off than she was when this started. Madison's body has adapted to her many obstructions/occlusions by forming venous collateral veins. These veins although small and many in number are getting her blood where it should go, it's just not taking the right path. Madi's procedure yesterday could have had a very different outcome in her experiencing serious life threatening complications in addition to not acheiving the results we had hoped for. We are truly thankful that she is home, watching TV, and being Madi.

As her parents we wish she felt good more than she does, we wished her head wouldn't hurt, and that she would have the same level of energy of other children her age. However, there are certainly a lot of parents out there that would gladly take all of those things if their child would stop being plaqued by some of the awful diseases that they have. All of the things I mentioned could be so much worse and quite honestly, we know first hand what those worse things are. So I am saying all that to say, that we are going to "Suck it up, & drive on" and hope for the best!

Although Intervention yesterday in the Cath Lab wasn't possible, Divine Intervention is possible! We are trusting that God has a plan for Madi and her life and that he knows right where we are right now. Yesterday, could have been a huge blessing that will be revealed to us in God's perfect time. We're okay with this...

I e-mailed some addtional questions today to her doctor and his nurse for which they responded quickly. Below are the questions and their responses. Many of you have been asking me these questions so I thought you would want to know the answers too.

Yesterday they found a blood clot in her left internal jugular vein. He indicated that this isn't a real concern.

Q) Why isn't this blood clot a concern?
A The reason that the blood clot is not a concern is that is an organized clot and it cannot break apart or have pieces dislodge from it.

Q) What are the risks of her having this blood clot?
No risks

Q)Does he have plans to give her something to break it up? Why or Why not?

No, there is no medicine to break it up. The thrombolytics that are used to break up clots have to be administered within 24 hours of its formation. And the time that this was formed is not known though it seems to be old.
The risk of attempting to break it up with medicines would be very high, and have increased generalized bleeding.

Thank you for all of your support and prayers through this, we've felt them!

Howard & Allison


Below are the highlights from yesterday's events that took place at Duke in the Cardiac Cath Lab....

Thursday June 5, 2008 7:30pm

Madi has eaten, got up, & walked around. She looks pretty pale but seems like she'll be fine with some rest. We plan to leave Duke to head home soon. Thank you for you prayers and your concern.

Allison

Thursday June 5, 2008 4:50

Madison is now awake and says she's starving! They have moved her to a room on the children's floor in the hospital. They want her to lay flat at least until 5pm and then we can try to sit her up and see how she feels. She says her head and her stomach are hurting right now. If she feels okay after while we will probably go home. We are trying to wait and make sure that she really does feel okay before leaving prematurely. We don't want to turn around and come back in the middle of the night.

Allison

Thursday June 5, 2008 3:20pm

After four hours they have moved Madison to the recovery room. With some trouble they were able to get the wire all the way through where they wanted it to go. Madison's veins are very small in the area they were going through. Because of this small size it was not possible to get the ballon through where it needed to go. They were unable to do Angioplasty or stints. They hope that as she grows that these small pathways will get bigger and give her some relief however, the Left Innominate Vein is really just completely flat and will not likely get bigger. They found a blood clot in her Left Internal Jugular vein. Dr. Rhodes was great but maybe somewhat disappointed that this procedure wasn't possible. He mentioned that we could talk to some surgeon's but his thoughts were that there really wasn't many places a surgeon could sew to because her veins are so tiny. We don't have plans to talk with a surgeon. At this point, it appears that she will just have to live the way she is and we need to be thankful for that. We are waiting to be allowed to go back with her in recovery. We will likely go home tonight depending on how she wakes up.

Allison

Thursday June 5, 2008 1:55pm

They just called us and indicated that they have been able to get a wire across the left femoral vein and over to the Left Innominate Vein. They are now attempting to get the balloon to that location and are having a hard time. If they are able to get the balloon over there they will then be able to perform Angioplasty.

Allison

Thursday June 5, 2008 1:00pm

They've just called again and said that Madison is still doing fine. They are still attempting the Angiogram. They were unsuccessful at getting the catheter into her Left Internal Jugular Vein because of the obstruction. This means that they have been unable to get in two of three catheters that they had hoped. They are currently attempting another route which is through the vessel below the heart, through her SVC (Superior Vena Cava) and over to her subclavian vein. They are still trying but indicated that they aren't very optimistic at this point.

Allison

Thursday June 5, 2008 11:45am

The team just called and said that they are still trying to complete the full Angiogram. They were attempting to put catheters in in three places. The catheter is in the left groin area. They tried unsuccessfully to put a catheter in the right groin area. They were unable to actually get it in because they found another occlusion with many venous collateral veins. We didn't know this was there.. This is new to the obstructions that we did know about. As of right now they are trying to put a catheter into her left internal jugular vein and will call back with progress. They confirmed that Madi is doing fine with the sedation.

Allison

Thursday June 5, 2008 10:40am

They took Madison back and we walked out of the room once she was asleep. It was around 10:15am. They've given us a pager and they said that they would contact us at least every hour. Madison had a good morning this morning and really didn't appear to be afraid. That's my girl! We'll update soon

Allison

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