Meth #2

Sorry I haven't updated in a while. I can't get my blog to work from my tablet at the hospital, so I have to save up all of the info and post from home.
Sierra had her second dose of Methotrexate on Wed, April 25. We went in for her check up first, where they access her port and draw labs to check her blood counts and make sure she is well enough for treatment. These appointments take a really long time, we got in at 10, had her labs drawn around 10:30 and didn't even see the doctor until around 1. Luckily Sierra is pretty happy to play in the playroom, and sing songs with the music lady that works there.

When we finally got called back to speak with the doctor, he asked how she had been feeling, which had been great up until the day before, when her mouth started giving her trouble. The Methotrexate is known for causing more mouth sores and pain. The doctor considered postponing her treatment for a day or 2 to give her mouth some time to heal, but decided against it because of her protocol, they really want to try to keep her on schedule with her chemo, in hopes of killing the tumor more completely before removal.

Sierra got her wig on Thursday, and it perked her right up, for about 5 minutes, she really likes it.

We were admitted and she was put on fluids to stabilize her PH before she could start the chemo. She didn't even start treatment until 9:30 at night. We were able to keep the nausea at bay these round as well, besides one short stint on day 3, but luckily no vomiting. We are struggling to get her to eat anything though, which means her weight is starting to drop. She started out, before treatment, at about 41lbs, but was down to 36lbs, when we checked into the hospital Wed. We really don't want her weight to go down much more, she needs the calories and energy to keep her body fighting.
She did quite a bit of playing this time around, especially playing Mario on the Wii. Her attitude was really crummy on day 2, but improved from there and she has been fairly happy and cooperative since then.

                 Riding her pole                                    Popsicles help with the mouth pain

We have had a few talks with her orthopedic doctor about surgery options, and will be having a final meeting with him soon to decide what we want to plan for. Her surgery will likely take place mid June, and depending on the surgery we decide on, we will get to go to a hospital in Portland to have it preformed.

Passed out sitting up

We haven't talked much yet with Sierra, but we have 3 surgery options. None of our choices are great, but we are hoping and praying that we will make the right decision for Sierra. I will outline a bit of each of our options, but we haven't made a final decision on this yet.
Option one: amputation
Because of the location of her tumor, this would be an above the knee amputation, around mid thigh, and she would use a prosthetic to walk.
Option 2: Limb salvage surgery
In this procedure, they remove the tumor and replace her bone with titanium, or cadaver bone. She would have a basically normal looking leg, but would lose a lot of function, and have to endure many more surgeries for lengthening her lag. There is also a high risk of infection with this procedure.
Option 3: rotationplasty http://www.youtube.com/watch?v=njJUcTbR2SY
While this surgery isn't necessarily aesthetically pleasing, functionally it is a good option. Basically Sierra's knee would be removed, and her lower portion of leg would be rotated so that her thigh and calf meet, and her ankle becomes her knee. She would still use a prosthetic, but would have much more control, and thus more function, basically changing from an above knee amputation to a below knee amputation..

Obviously we have a lot of choices to pray about, but I know we will be guided to do what is best for Sierra.