1. Mighty Mercer

Mercer was hospitalized in October and again in November for seemingly small issues— an ear infection, and a cough. Blood work showed his hemoglobin was very low and he needed blood transfusions both times. They couldn’t identify the reason his bone marrow was not producing the hemoglobin correctly, so a bone marrow biopsy was ordered. When the results came in unusually quickly after the biopsy, we were given the diagnosis of B-cell Acute Lymphoblastic Leukemia.

This is the most common type of cancer in children, and has a high rate of remission. Mercer’s case has so far been a typical presentation which means we’re going to follow the most common “Plan A” treatment. It was caught fairly early which makes treatment smoother. And his young age makes some of the side effects and risks lower!

He was immediately admitted to BC Children’s Hospital and the oncologist gave us the treatment plan. Leukemia is a blood cancer and instead of his bone marrow producing healthy cells, there is a genetic error and his marrow is replicating immature cells that are growing much faster than anything else. That means his bones are basically swollen with unhelpful cells, crowding out the healthy ones. This also means his bones can hurt and his blood levels will all be negatively affected. Low hemoglobin means low energy. Low platelets mean more bruising and bleeding. And low white cells means more infection.

Childhood Leukemia is not like some other cancers you might be familiar with— there is no tumour and it’s also not caused by anything within anyone’s control. It’s just an unknown genetic fluke that causes a production error in the blood assembly line.

Treatment for Mercer means killing off the cancer cells quickly in phase one, then keeping them eliminated in phase two. Phase one is 35 days of intense chemotherapy: a standard combination of medications that have a wide variety of side effects to be mindful of. The doctors and nurses have strict protocols and are very careful to ensure the side effects are managed. The first week or two of this phase will be inpatient where he is monitored closely. The remaining time will be outpatient while Merce and I are at Ronald McDonald House.

Leukemia cells like to hide in the body in a couple predictable places and one of those is the spinal fluid. The doctors check to see if the Leukemia has spread there and currently Mercer is showing no signs of Leukemia cells in his spinal fluid. This means a continuation of treatment plan A (which is what we want!). They check this by doing a lumbar puncture. At the same time they check, they also administer chemo medication into the spinal fluid as prevention.

At the same time as the lumbar puncture, which happens under anaesthetic, they install something called a port. It is a medical device placed under the skin in the chest, kinda the size of a cherry. It’s connected into a deep vein via a flexible tube inside the chest. The skin heals overtop of the port and it stays in the duration of treatment. When it’s accessed, a needle is placed into the skin over the port and a bandage goes over and then a tube easily connects and can give medications, or can take blood, easily and effectively without needing more pokes or an annoying IV. It can stay accessed for days at a time without being removed or replaced! When it’s un-accessed, it’s just a small bump under the skin and you can bathe and swim and play without restriction.

Mercer received his lumbar puncture and port on his fourth day in the hospital. This also means chemo treatment can begin! So the following day, Saturday, was day 1 of treatment.

The first 35 days are a fast and furious treatment designed to eradicate the cancer cells. He receives a combination of about five different chemo drugs on a very orderly schedule. Some are through the port, some are oral, and some are inserted into the spinal fluid. They have a variety of side effects and risks that are managed carefully by the team and other meds can help ease issues (nausea, constipation, sleeplessness, low appetite).

Most of the time, the body responds well to this and when they test around day 35 the results show no cancer cells. This means phase two begins— a slow and steady treatment of about 23 months to ensure the Leukemia is truly gone. It requires a lengthy treatment to completely eliminate it and reduce the chances of it coming back. We’re praying that on day 35 Mercer’s results will show zero cancer cells which would mean a continuation of plan A and a move into a slower, steady pace. If there are still signs of Leukemia cells present on day 35 then we shift into plan B and take a stronger approach.

Two years is a long time! But obviously any length of battle is worth it when we know what’s on the line. The biggest question for our family personally is how much of that battle happens in Vancouver. The answer is 6-8 months of Children’s Hospital outpatient care in Vancouver. Our home base will likely be the Ronald McDonald House on the hospital grounds. The remaining 16-18 months will be with Nanaimo as our home base and routine trips to Vancouver.

Family wise this obviously causes a lot of upheaval. I (Georgie) will primarily stay in Vancouver and keep continuity for Mercer and focus on him and his treatment. And Christian will have Conrad and Vance and keep continuity and “normal” life going for them in Nanaimo. Thankfully there are numerous opportunities for visits in both Vancouver and Nanaimo and the team here knows the value of family time in the healing process!

As I’m writing this, Saturday night, Mercer is completing his first day of the aggressive 35 day “phase one”. We are surrounded by the most fantastic staff and are receiving the top notch care. Mercer’s case is presenting as typical and common and unremarkable which is exactly what we want — the boring, garden variety blood cancer with expected results and progress!

I am unbelievably grateful for all of the dedicated and attentive care we’re receiving here, for the love, support, and generosity of the massive community I find myself blessed to be a part of, and for the incredible spirit and strength each one of my family possesses.

I hope this update gives you some clarity into what’s going on, what to expect, and what we’re hopeful and praying for. I’ll be continuing to update as treatment goes on and look forward to sharing positive news with you all!

I like words and quotes and often times in hard seasons we can hold onto phrases or mantras or prayers to help us keep focus on the important things and I can’t help but think of a quote I’ve loved for a few years now that I found in another moment of huge difficulty…

Julian of Norwich, credited as author of the earliest written work in English by a woman, was extremely ill in her 30s and was nearing death when she experienced visions from God. She remarkably recovered and wrote about those visions in a work called “Revelations of Divine Love”. She lived on over thirty more years and her words have brought comfort and inspiration for several hundred years and I think of them often and most especially now.

“All shall be well

And all shall be well