Good evening!

Happy first day of school to all of the amazing children and teachers in our lives who will start their first day of school this month.  As a teacher, I know the excitement of having the kids walk in the room for the first time is one of the greatest moments of the year.  It is a time of new beginnings, excitement for the year ahead, and an opportunity to reach goals you didn’t know were possible.  

We have spent the last three weeks gathering information, completing several diagnostic tests, and meeting Nathan’s extensive team of doctors, both here and in Boston, to make sure we have all of the necessary information to best treat Nathan.  We have received overwhelming reports from everyone that they believe Nathan is doing extremely well.  

His last chemotherapy treatment was on April 11th.  I could not be more excited to say that next week Nathan will be chemo free for 5 months!!  His MRI last week showed that the tumor has continued to remain stable which is a critical piece to treating low grade gliomas.  The doctors feel that if we would have seen a rebound from the Avastin therapy it would have most likely happened during the first three months off treatment.  Although this was not the treatment plan that was outlined for Nathan in April, we trusted ourselves and Nathan’s medical team to feel comfortable enough to just wait and watch for a few weeks.  A few weeks has now turned into a few month.  We can only hope that a few months will turn into a few years of no treatment.  We know the key to treating Nathan’s tumor is to find that stable period for several years where no treatment is needed so we do not exhaust a decreasing list of possible chemotherapy options.  We will continue to wait and watch his neurological symptoms in hopes that they do not progress and through specialized therapies he learns to overcome the deficits. 

Since Nathan has been on therapy since he was 10 months old, we only know a Nathan who battles the effects of chemotherapy and never complains.  We never realized just how much it was effecting him.  We had no idea what Nathan’s body was capable of physically until we watched the recovery process happen this summer.  It has been the greatest summer we have had in five years.  Nathan is strong, he is full of energy, he is challenging himself, he is keeping up with the other kids, and most of all he feels confident to take risks and push himself.  A few weeks ago he tested for his first Tae Kwon Do belt.  We all sat there while he did everything the Master asked of him without rest and without modifications.  If you told me 6 months ago what he had to do, I would have said there will need to be exceptions because Nathan can not physically do those tasks.  Well, I was certainly proven wrong and I couldn’t be happier.  My family and I all sat there and supported Nathan as he proved to us once again, I am not giving up. It was one of those special moments of firsts that we will never forget. 

As you know, Nathan’s oncology care brings us to Dana Farber Cancer Institute in Boston.  We usually go every 10-12 weeks following Nathan’s MRI.  Over the past three months we have had to go every month due to the leave of his oncologist in Pittsburgh.  We are always so grateful to Mike and Jaime for opening their home to us.  We could not do this without them. They turn our “business trips” into days full of laughter and fun.  During our last night there, we had the opportunity to spend the evening with two of their best friends, Lori and Kenny.  They are an amazing couple of deep faith and commitment to their Mormon church.  We had never met Kenny and he didn’t know very much about Nathan.  The first thing he asked us was, “What is the most important thing you have learned from your experiences.”  I must say, that took me a little off guard since we have never met.  What a great question to ask.  I have not been able to get that question out of my mind since he said it.  That question is hard because it really is what defines our family.  I would love to say we are the same old happy go lucky family that we were five years ago.  I would love to say that we lead a normal life.  I would love to say that we try not to let it effect us, but none of that is true.  This experience is now what dictates how we spend our days, our relationships with family and friends, how we look at our future, and most importantly our faith in God.  That simple question is one we should all ask ourselves.  If we don’t stop to reflect on how the “good and the bad” have changed us then the experience is useless.  Nathan’s fight to a cure can not be useless. To find purpose in this challenge we have been faced with, Mike and I have tried to use what we have learned to educate other families, support the causes we believe in most, and show God that we will always live in a way that He chooses for us.  We were not given a choice when we received Nathan’s diagnosis on June 2nd of 2012, but we are given a choice of how we use these experiences to shape not only our lives, but the lives of everyone we meet along the way.  Nathan and all of his little friends who fight for their lives every day give us the guidebook to life.  If we are willing to just take a moment to stop and watch, these children teach us everything.  They teach us to be genuine in our relationships, honest with ourselves, ask for help when we need it, cry when we are scared, and believe that anything is possible if you love deep enough.  Nathan absolutely knows that he is loved by so many people and they are counting on him to be the best he can be. 

On October 1st, Nathan will celebrate his 5th birthday.  This will be his first birthday where he will be chemo free!  Now that is something to celebrate!  He and Samuel have chosen a superhero theme which seems to be a perfect fit for this year. Just like the first day of school, we are certainly living a time of new beginnings with no chemo, excitement for living the next three months without frequent doctors appointment and heavy medications, and watching Nathan achieve goals we never thought were possible.  The diagnosis never goes away, so it is hard to celebrate where we are.  Although, you better believe we take these times to breath deeply, recover from what we have had to do, and thank God for each healthy day. 

May God continue to guide you as you battle your own challenges in life.  So many of our close family and friends have significant health issues of their own, yet never forget us.  My final prayer ever night is, “Thank you God for all of the prayers you receive for Nathan every day.  I know you are listening.  Please pray for those who remember us every day. “

Thank you all!

Love,

Mike, Beth, Nathan, and Samuel

www.nathanleckey.blogspot.com

Thank you for all of your support with the Make-A-Wish fundraiser in July.  We hit the $10,000 mark and will be able to fully grant between two and three wishes.  Since we are fully funding a wish, we will be considered wish makers and be able to follow the wish we are funding.  I will keep you informed of what the children choose and send pictures.  You can also follow their progress on Nathan’s blog.  Thank you to Bob and Debbie Busteed for an amazing day for the kids!

June 2, 2016

Summer is here!

I know so many of you are celebrating these last days of school and the beginning of fun summer activities.  There is no greater feeling for a child than the last day of school!  Enjoy every second with your friends and family and safe travels during all of your summer vacations. 

Today we are full of many different emotions and feelings.  Four years ago today, Nathan was diagnosed with his brain tumor.  He was admitted to the hospital at 7 months of age and we had no idea what was about to hit us. We spent the next 32 days at Children’s trying to help our baby recover from brain surgery.  This is what people mean when they say, “You can’t prepare for tomorrow, so make sure you enjoy today.” From two weeks of age we knew something was not right with Nathan, but we never imagined we would receive the devastation that the diagnosis of a pediatric brain tumor brings. 

On June 2nd, 2012, our lives were forever changed when Nathan came out of his first MRI.  Little did we know there would be 24 more to follow and over 80 chemotherapy treatments before his 5th birthday.  The memories of June 2nd are ones I try not to visit very often, but they are memories that humble us and make us who we are today.  They give us the ability to fight for Nathan’s health with everything we have.  They are the memories that will forever change the way we look at each day and the relationships we have.  I don’t forget those memories, I try to use them to make a positive impact on our lives moving forward. 

I can remember the conversation like it was yesterday that we had with the oncologist for the first time.  Our bodies were tired, our minds were numb, but we knew we had to focus to give Nathan the best possible outcome.  She outlined what the coming days would look like and the typical plan for a child like Nathan.  As tears came down my face, I can remember asking her, “Will Nathan make it to his first birthday?” She quickly replied, “Yes, and we will make sure he has many many more.”  She was right. 

Today, we don’t forget those difficult weeks in 2012, but we do take time to celebrate what we have been given four years later.  On March 7th, Nathan had his last MRI.  At that time we were in an extremely difficult place.  The scans were not giving us the information we needed, but Nathan’s body was telling us it was time to switch chemotherapies. Due to side effects, he could no longer stay on Avastin and we had to choose yet another treatment plan for Nathan. We spend several weeks making sure we did everything we needed to in order to choose the right path for Nathan.  His next course of treatment was initially denied by insurance.  We spent three weeks working with the insurance company to get the necessary approval.  At that time, we were beside ourselves because we knew we needed to get started on something quickly.  Nathan’s kidney functions were also elevated, so even if we were able to start therapy, we had to wait for his kidneys to recover.  There were quite a few things that were not moving as quickly as we needed, but we are grateful for the unexpected administrative and medical hang ups because they completely changed the course of Nathan’s treatment plan.  As a result, we are in a much better place. 

Over the past few months, Nathan’s symptoms have gone from periods of extreme concern from everyone involved in his care team to looks of total confusion.  His symptoms are all over the place and are not giving us enough indication that we actually need to start the next treatment.  He had an MRI last week and the scan was completely stable.  Although this is what we pray for, we were not certain that is what we would see.  If there were not a series of complications that occurred over the past two months, we would have started on his next chemotherapy they he truly may not need right now.  We will meet with his doctors in Boston at the end of June to reassess the plan, but as of now, Nathan has been chemo free for 8 weeks and it is our every hope that he will remain that way for awhile.  We don’t know if we will have to start therapy in a week or a year, but we are certainly trying to make the most of every day he gets without the heavy medications in his system.  He started chemotherapy when he was 10 months old and besides a three month break last year he has been going nonstop.  His body is very tired and is ready for a much needed break.

We are certainly not following a clear path, but we are trusting ourselves to be patient enough to wait and watch.  There are so many balls in the air with Nathan’s case and we hope we are doing everything right to give him the best chance for a healthier life.  In addition, we also found out that the only neuro oncologist in Pittsburgh has resigned and we will be transitioning to a new team of physicians in several months. The most important thing the children in the neuro oncology clinic need is consistency.  Our prayer is that the right minds come into our children’s lives to help guide the collaboration that is necessary for a case like Nathan’s. 

One of the highlights of this past year has been Nathan’s Make-A-Wish.  Two years ago, many of you joined us at Bob and Debbie Busteed’s home for a spectacular night of fundraising for Nathan’s fund.  We raised close to $25,000 in one evening for pediatric brain tumor research.  Bob and Debbie have dedicated themselves to helping others in need.  They are an inspiration to me in so many ways.  They have once again decided to do a fundraiser for a cause they believe in.  Debbie called me a few weeks ago and asked me if I would choose where we would like the money to go.  Make-A-Wish has not only touched our lives, but it has made a positive impact on so many of our friends from the hospital.  It gives families of children with life threatening illnesses a moment of hope and joy.  It brings smiles to the faces of so many kids who show their strength and bravery day after day.  Without a doubt, we would like to give back to Make-A-Wish this year by participating in this amazing day of fun.  Please open the attached invitation for details of this magical day on July 9th.  Debbie, Keely, and myself would love for you to join us in supporting this great cause.  I would like to give a huge thank you to Debbie and Keely for everything they are doing to make this day perfect!

As always, you are all in our hearts and prayers.  So many of you have made Nathan your devotion and daily prayer.  There is not a doubt in my mind that God is listening and hearing us ask for help and guidance.  He is giving us the peace of mind we need during periods when it would be easy to overreact or lose trust.  Thank you for walking this path with our family.  We need you and we appreciate you all.

Happy Summer!!

Mike, Beth, Nathan, and Samuel

Nathan in Hilton Head, SC April 2016

Our favorite spot in the hospital, the 6th floor patio overlooking the city

Nathan's 1st T-Ball Game

His favorite superhero shirt and mask he made to help him get through the day

Happy Spring Everyone! 

As I am writing this update, the back door is open and I hear the chimes and wind blowing.  It feels like spring and a time of new beginnings.  For Nathan, the past three months have given him many opportunities for new beginnings.  He has truly grown into a little person with independent thoughts, a wonderful imagination, and is full of love and compassion.  He is a people person like his parents and Samuel is following in his footsteps.  

Nathan’s last MRI was on March 7th, almost a month ago.  I usually write these updates shortly after the MRI, but this email is late given the variety of decisions we have been faced with over the past few weeks.  We were very pleased to hear that Nathan’s MRI looked stable from his scan in December.  Unfortunately, Nathan is telling us that something is going on that we are not able to see on the scan.  Due to the tumor being deep within the brain stem and the effect of his current chemotherapy on imaging, we are unable to trust the scan to give us an accurate picture.  This is extremely frustrating.  We want to have concrete information to guide our decisions, but our current circumstance does not give us that opportunity.  We have to trust our instincts as parents to know Nathan so well that we can pick up any subtle changes we see.  Every day I have to chart 14 different categories from sleep and voice quality to the number of hiccups and times he coughs while drinking in order to try to identify trends that would give us information of progression or decline.  That is the only thing the doctors have to make some very serious decisions about how to treat him.  The hardest part is that Nathan is a child who has good days and bad days just like every other four year old.  We are grateful to the wonderful therapists and teachers that work with him to help us sort through a very intricate process.  Nathan has also developed some complications with his kidney’s due to the toxicity of Avastin.  Even if Nathan’s symptoms were stable and Avastin was working, we would still have to stop due to his kidney levels.  This was the first time we had to consider long term effects on his body when choosing to stay on a treatment.  We are starting to learn that after the body has been given so many heavy doses of medication, there is a true art to finding the right balance of push and pull.  We are confident that our oncologist is a master of that art. 

After Nathan’s MRI, we went to Boston to see his neuro oncology team.  We were hopeful all of his doctors would let Nathan stay on Avastin for a few more treatments to see how his symptoms would develop over the next few months.  They have a very aggressive approach to treating tumors like Nathan’s because they know it does not take much for long term function to be lost.  They always follow the philosophy that the goal is for Nathan to be symptom free.  Any time he has symptoms, his body is giving them the information they need to treat the tumor.  In that appointment, we were reminded how serious the placement of Nathan’s tumor is.  I found myself looking at the doctor, but unable to hear what he was saying at times because I didn’t want to believe it.   I have been blessed to know many great teachers and he is by far one of the greatest educators I have ever known.  I know the tone that good teachers use when they want you to understand what has to happen to be successful.  Dr. Kieran had that tone when he for the first time said, “We cannot afford to wait and watch.  The functions that Nathan’s tumor effects cannot afford to be compromised.”  My eyes filled with tears and my heart dropped,  but I heard his words and trusted him.  Those words have stuck with me and helped me to accept that it is time we have to change to yet another therapy.

The tendencies of a majority of low grade gliomas tumors like Nathan’s are to go through different waves of treatment and stable periods until they eventually stabilize on their own anywhere from age 11-22.  What makes Nathan’s case so risky is that he was diagnosed at 8 months of age and his current tumor is inoperable.  We have a lot of time to buy and there is nothing that can be done to remove what is remaining.  A majority of children find a time of stability off therapy with their first or second treatment.  Nathan is four and will now be on his sixth treatment.  We are now moving into drugs that are not standard treatments for low grade glioma tumors.  We have had to consider very young clinical trials where toxicity profiles are unknown and traveling for treatments would be necessary, off label uses of FDA approved drugs, and chemotherapies that have long term risks that we would not like to take.  

We have had to learn a significant amount about genetics and how it effects the treatment of Nathan’s tumor.  We have now entered the world of targeted genetic therapies.  The fact that my brother is a leader in the field of genetics and runs a lab for Human Genetics Research in Boston is absolutely amazing.  He has been able to educate us on complicated science that the average music teacher and CPA parent do not understand. After a great deal of research and many conversations with his doctors, we have decided to go with a drug called Everolimus.  It is one of the first drugs approved for children that is targeting a specific genetic mutation.  It was developed as an anti rejection medication and for children with tuberous sclerosis complex.  We have had Nathan’s tumor genetically mapped and know that he has the exact mutation the drug is targeting.  The BRAF pathway has been a focus of cancer treatment for many years.  The mutation associated with melanoma is the same mutation found in many low grade glioma tumors.  Therefore, the drugs designed to inhibit this mutation in melanoma may be active against Nathan’s tumor.  Unlike other younger targeted therapies that are available right now, we know this drug has over 20 years of toxicity results and data in children.  In patients with Nathan’s mutation, it has a high success rate for either shrinkage or stability.  We believe in the science of these therapies and know they have potential to make significant changes in a tumor like Nathan’s.  Like any therapy, it does not come without risk and side effects, but it is the safest option we have. We feel very confident that this is the path for Nathan right now.  The decision did not come without many sleepless nights and deep prayer.  My brother said to me a few weeks ago, “You have already made the decision, now you just have to understand why you made it.”  He was right. 

The last thing a parent wants to hear is that a treatment for your child is no longer working and you have to explore other options.  Although we wish we could stay on course, we feel truly blessed that Avastin worked so well for Nathan for almost two years.  That is a significant amount of time on one drug. He has had time to learn how to drink regular liquids for the first time in his life, he has learned how to ride a bike, he has learned how to read and write, he has learned how to jump, climb, and swing.  Nathan is able to play soccer with his peers, keep up with all the other kids in Tae Kwon Do, and will start T-Ball this week. These are all things that a parent who receives the diagnosis of a brain tumor in their 8 month old baby do not take for granted.  These are things Nathan has worked hard to learn and he fights hard every day to be just like everyone else.  We will not stop helping Nathan until we feel he has every tool he needs to be as strong as his body allows him to be. 

Nathan continues to go to therapy three times a week to gain strength and endurance for his weaknesses.  He is extremely aware of what goes on around him and I know he senses something is different right now.  I know that all of the anxiety, worries, and fears have to go into a little box that we cannot open because it is our job to make Nathan feel safe.  He wants to watch everything that goes on from placing the IV’s to having his feeding tube changed last week.  He does not take his eyes off of the people working with him.  He has learned to breathe through difficult situations and be brave through procedure after procedure.  He is asking more and more questions that I often don’t know how to answer.  I have met some amazing parents who are going through similar situations.  They have helped me to find the right words at the right time so Nathan understands his situation without being fearful of what goes on.  Nathan and Samuel are best buddies.  They find great comfort in each other.  God knew what he was doing when he gave us these two little angels.  They just play and hug all day long. They make this path one that I would never trade because it makes us who we are.  The four of us depend on each other for comfort and strength.  We are all in our happy place when we are together.  We know that life is precious and time as a family will always be a priority and something we cherish most in our lives.

The past month has probably been one of the hardest months for us since Nathan was diagnosed.  There were many realities of his prognosis and long term treatment path that we have had to face all over again.  There have been memories and realities I wish I didn't have to revisit.  After I spoke to the doctor tonight, I felt great peace that we are on the right path.  Spring is a perfect time to accept this new beginning and give every ounce of energy we have to making it as positive as we can.  It is a chance to start the healing process again.  It is a chance for Nathan to be one step closer to stability and a cure.  It is a chance for us to enjoy our precious Nathan during every beautiful day that God gives us.  

Thank you all for being part of our lives.  Your encouraging words are what make the hard days easier and the good days worth celebrating.  We love you and thank you for the commitment you have made to helping our family through this challenging path. God knows we cannot do it alone, so he has given us all of you. 

Much love,

Mike, Beth, Nathan, and Samuel 

Samuel and Nathan in their matching shirts. They will help each other to be strong and keep fighting!

One happy Easter boy!

Another great trip to Boston. He loves his new Boston snoopy hat.

Just get a few last minute hugs before school

Happy as can be in his new swing set

Riding his first big boy bike for the first time

Good evening!

Winter is here and the Holidays have arrived. Every morning Nathan runs downstairs to see where his elf, Sydney Crosby, has landed.  He then loves to FaceTime his family to see where their elves have landed.  It is the highlight of his day.  This year has been especially exciting because our newest family member, Meredith, has been sharing her Hanukkah traditions with us every day.  It has been such a wonderful addition to this already magical time of year.

The last update I sent was in August.  At that time, Nathan’s neurological symptoms were regressing and he had to start back on an every two week chemotherapy regimen.  Since then, Nathan has received 9 rounds of chemo and he has again stabilized.  Neurologically, he is doing very well and the MRI last week showed exactly what we are seeing.  The tumor is the same size as it was at the end of September.  There actually has not been any major changes in tumor size since the fall of last year, but Nathan’s symptoms often change before we will see anything on a scan which guides the need for treatment.  

One of the biggest accomplishments over the past few weeks has been that Nathan is starting to trial small amounts of regular water.  Due to his compromised swallow and paralyzed left vocal cord, all of Nathan’s liquids are thickened and we use his feeding tube for 90% of his hydration.  This is the first time Nathan has ever been able to drink thin liquids without immediate signs of aspiration.  He has also made great strides with his physical and occupational therapies. He is starting to do things independently and is using the left side of his body at a more age appropriate level.  His voice has also gotten significantly stronger.  He is able to find high and low sounds for the first time and keep up with all of my crazy songs that I sing all day long.  He is in a good place right now and we could not be happier.  The biggest challenge is finding a way to keep him in this positive place with the least amount of toxicity.   

At this point, we will start to space his chemotherapy treatments to once a month and hope that his symptoms remain stable.  After we stopped this chemotherapy in April, he started to regress within 6 weeks. Unfortunately, we are starting to see some side effects from the chemo that we hope do not effect his ability to remain on this treatment. He has developed neuropathy/joint stiffness in his ankles and feet, a limp, and high blood pressure.  It breaks our hearts to see our little four year old get out of bed every morning and struggle to walk for the first hour of the day. Although these complications add to the complexity of his care, we do appreciate the bigger picture of stable scans and overall neurological health. We 100% believe that Nathan’s neuro oncologist in Boston puts the preservation of Nathan’s body and development before any other decision.  He looks at the comprehensive picture and does not ignore even the smallest of details. 

One of the biggest challenges of managing a child with a brain tumor is that it truly effects Nathan’s entire body.  During our several appointments in Boston yesterday we addressed concerns over facial nerve stimulation, vocal cord function, swallow function, inter cranial pressure, pathway inhibitors and their effects on genetic mutations for Nathan’s tumor type, neuropathy, blood pressure, the list goes on and on.  We often leave appoints extremely overwhelmed because so much of the terminology is new to us.  We are an accountant and a musician and now we are expected to make life changing decisions on very complicated medical issues.  We have to accept that so much of this is out of our control.  There are not always answers to important questions.  We have to be patient, not panic, and always educate ourselves to the best of our ability to make sure Nathan is safe during these fluctuating times. Our own insecurities and worries must always take a back seat so we can see through a focused lens and help Nathan.  My final prayer every night is asking God to help Mike and I make the right decisions for his medical care because it the biggest responsibility we will ever have. Recently I have had more moments of wishing our days of hospitals, therapies, and medical management were less.  I only let my mind go there for a minute and quickly realize that God trusted us to do this job and we will do whatever it takes to make sure Nathan gets what he needs. 

Last year, Nathan was nominated to be a Make-A-Wish child.  We have been working with this wonderful organization throughout the past year to help Nathan fulfill his wish.  We all know the name Make-A-Wish, but through this process we have learned what this absolutely incredible group of people do for kids like Nathan and we could not be more impressed. On November 27th, he received his wish to have a truck play set.  He still loves his trucks more than anything in the world and wanted a truck stop where he could serve them food and the truckers could get out and play.  Well, they fulfilled his wish far beyond our wildest dreams.  I think one of the best parts for Nathan was watching the set be built in the yard.  He did not leave their side as they bolted on each piece. This amazing weather has allowed Nathan and Samuel to enjoy the play set every day.  It brings us such joy to see him being a kid, climbing, jumping, and swinging just like he should be.  We are so appreciative to Make-A-Wish and the smiles they bring to kids like Nathan.

Every time I look out our window and see the play set it reminds me what is achievable when you fully commit to a goal.  Nathan spends 3-4 days a week in therapies to make his body as strong as it can possibly be.  Last week he received his 75th round of chemotherapy and more IV’s than I want to remember. He never once complains or questions what is asked of him.  He does every single thing the doctors tell him to do and therapists ask him to practice. When the countdown happened and the kids all went on the play set when it was finished I did not feel bad that Nathan was a Make-A-Wish child, I felt peace that he was healthy enough to enjoy this incredible gift. 

The Holidays are here and we all have so much to be grateful for this year.  It is always humbling to spend time at Children’s Hospital, or as Nathan calls it, “my hospital.”  There are so many sick children that will spend their Christmas in a hospital bed instead of in their homes.  We are grateful for the perspective we have been given and pray that we never take even one day for granted. 

You have all followed this journey and supported us every step of the way.  Each month brings a new challenge, but your constant encouraging words give us the strength and faith to do our jobs as Nathan’s parents to the best of our ability.

We wish each of you a very blessed Christmas, a happy Hanukkah, and a new year filled with health and love. 

Love,

Mike, Beth, Nathan, and Samuel

Nathan and Samuel on his Wish Day. Samuel is Nathan's best friend and number 1 supporter!

Getting ready for his MRI on December 2nd

Enjoying his favorite s'mores donut from Peace, Love, and Little Donuts while watching his swing set go up. 

August 3, 2015

Nathan received his first Avastin treatment of the second round.  We thought he may have trouble getting back into the routine because he has been off for over three months, but he handled things way better than mom.  They were able to place the IV quickly and everything with the infusion went as smooth as possible.  He will receive treatments every two weeks until his symptoms stabilize.  We will then begin to space them to every 3, 4, 5, and 6 weeks as long as his symptoms are manageable.

Avastin Infusion

Lego crafts on the 6th floor!

Nathan was so excited to be able to spend the day with Pap...even if it was at the hospital.

August 2, 2015

Good evening,

I hope you are all enjoying the summer as much as we are.  After the rain in Pittsburgh finally stopped, we have enjoyed our time playing in the yard, riding bikes, and playing at the park. We have tried to make the most of every day that Nathan has been chemo free.  We waited almost three years to get a break, so we did not take it for granted.

Last week Nathan received the first MRI since he stopped chemotherapy on April 27th.  After each scan, we travel to Boston to meet with his team of doctors. There is a period of time that we spend gathering information and opinions from numerous physicians at Children’s Hospital of Pittsburgh and Dana Farber Cancer Institute in Boston. It is a complicated coordination of care with many different ideas on approaches to treatment.  Although it is confusing at times, we feel that Nathan has some of the greatest minds in the field working on his case.  We are confident that we are gathering as much information as possible before making a decision on how to best treat his tumor and symptoms.  Unfortunately, his case is not straight forward, predictable, or easy.  He is young and his response rate to standard chemotherapy has not been positive thus far. 

On April 27th Nathan finished his one year cycle of Avastin chemotherapy.  Making it to the one year mark is always a huge accomplishment.  Nathan’s neuro oncologist in Boston reminded us in April that we will hope for stability and even if it lasts a few months that is ok.  The overall MRI scan appears to be mostly stable at this point.  There are areas around the visible tumor that appear to be enhancing slightly from the last scan.  Based off of the scan alone, things look quite good.  Although, when treating Nathan’s type of tumor, his current symptoms out weigh any MRI images.  If he is symptomatic it is most likely because the nerves are being compressed in the brain stem and the symptoms are preceding the scan.  

Due to the placement of his tumor, many areas of his body can and are effected.  There are certain symptoms that we can wait and watch and there are others such as swallowing and breathing where there is no room for growth.  Unfortunately, those critical areas have declined since his last MRI.  We believe he is aspirating his own saliva which causes him to regularly cough, choke, and could possibly be the cause of his most recent symptom of breath holding. In addition, he is starting to have weakness on the left side of his face which causes other challenges such as drool, weakened ability to chew efficiently, and inability to swallow liquids safely.  I keep a detailed daily summary of each of Nathan’s symptoms and the frequency in which they occur.  This becomes the basis for many of the decisions on treatment. 

The doctors are not sure at this point if the symptoms are coming from inflammation that can happen after coming off of Avastin too quickly or there is true tumor growth.  Unfortunately, the only way to tell and protect any new growth at the same time is to start back on chemotherapy every other week.  Nathan will receive his first treatment tomorrow morning. 

This has been a long road for all of us and I would be lying if I didn’t say we are all tired.  It is hard to accept that we have hit yet another detour.  It is extremely difficult to watch certain symptoms decline and just sit back and watch.  As much as we want to pretend everything is ok, we know it is not and we know this is the path we have to take right now. One of the biggest challenges of managing pediatric brain tumors is making sure any one nerve is not compressed to the point where the damage can not be repaired.  We have to do everything we can to help Nathan’s swallow continue to strengthen.  

Our every hope and prayer at this point in time is that Nathan will receive two or three rounds of chemo and his symptoms will return to his baseline.  At that point, we can spread apart the frequency of the treatments and slowly ween off again.  We will trust Nathan’s doctors to use their many years of experience to manage any new tumor growth and control his symptoms. 

I have not told Nathan that he is going back on chemotherapy.  He has been so proud to tell people that he is chemo free.  After a long week of travel, tomorrow will be another one of those challenging days as a parent. I have to look at my little three year old and tell him we will be going to the hospital for his medicine and he has to start getting IV’s again.  I am sure he will have a thousand questions and will make the most of the situation like he always does.  I hate that I count on him to give me the strength to get through these difficult times. He really is my rock. His smile, his energy, and of course his laugh will make all of this manageable.  

I know you all pray for Nathan regularly.  I am confident God is hearing our prayers.  I ask him every night to help Nathan heal from the inside out and to help his body to fight this awful disease.  He is certainly not giving us the most direct route to a cure, but I know if we are patient and strong Nathan will get there.  We will all make sure he gets there because there is no other option.  

Thank you for all of your love and strength.  We have the most incredible support system in the world!

Much love,

Mike, Beth, Nathan, and Samuel

He just loves these Minions.  This is what happens when dad takes him to Target.

July 23, 2015

First follow up MRI after stopping chemo on April 27th.

4th of July with his best buddy!

April 30, 2015

Good evening!

Winter is finally over and spring has arrived!!  This is one of my favorite times of the year.  There is nothing better than seeing the grass turn green and the flowers start to bloom. It is a sign of new beginnings.  Nathan was hit with quite a few viruses and two rounds of pneumonia over the winter.  It is so nice to see him playing outside and running around with his trucks. I could watch him run around the back yard chasing a ball and pushing his trucks all day. He absolutely loves being outside. 

This has been an exhausting week in the Leckey house, but by far the greatest week we have had since Nathan was diagnosed three years ago.  He had an MRI on Monday and the tumor has remained stable since his last MRI in February!  He finished his one year cycle of Avastin and received his last dose of chemotherapy on Monday.  It has taken me four days to actually believe what I am saying…Nathan finally gets a break from chemotherapy.  In my update several months ago I wrote in capital letters what I had in my head for so long…THE TUMOR IS SHRINKING.  This update was another one that I have written in my head over and over and have never been able to write.  Now that it is true,  I think I will say it just one more time…NATHAN IS CHEMO FREE!  He was walking around all day today saying thumbs up to being chemo free mom!  Needless to say, I cried every time. 

He has received 66 rounds of chemotherapy and been under general anesthesia 23 times since he was diagnosed on June 2, 2012.  When I woke up this morning I had to say it out loud to actually believe myself.  Our little fighter has been going nonstop, never complaining, and now he finally gets what he deserves….a break!  Just like all of the beautiful flowers that are about to bloom, Nathan can finally grow and develop without battling the toxic chemotherapies his little body has had to endure for three years. We took lots of pictures of his last treatment and he must have gone through them ten times today.  He kept showing me the picture of the MRI I had on my phone and said, “Hey mom, that’s the inside of my brain. Did you know it is all better now?” Kids pick up on everything!

We traveled to Boston on Tuesday and met with his team of doctors yesterday. They gave us great reports and think Nathan is doing very well.  They believe his symptoms are stable and feel confident stoping therapy is the right decision.  He will receive his next MRI in three months.  Avastin is a complicated drug because it can change the image of the MRI.  It is often not clear exactly what the tumor is doing until you stop therapy and let the brain go back to its baseline.  His oncologist believes it will take about six months for the scan to give us true information.  It is critical that we monitor Nathan’s symptoms very closely as that will be a better sign of what the tumor is doing.  Once again, we were reminded that we have some of the greatest minds in the world working on Nathan’s case.  His oncologist in Boston is on the cutting edge of every medical development pertaining to pediatric brain tumors.  His lab has over 60 scientists working just on low grade glioma tumors which is Nathan’s tumor.  We fully trust them to manage this delicate time in Nathan’s care. During these three months off therapy Nathan will continue to receive weekly physical therapy, occupational therapy, and speech therapy.  Now is the time to push him because his body will be strong and accept the treatments.  He works hard for the therapists.  His work ethic is incredible for little guy…then the therapists leave and he gives mommy and daddy a run for our money just like a three year old should.

The past few days have been filled with smiles and hugs.  When I opened my eyes this morning I just looked up and said, “Thank you!” God is hearing each and every one of us and is answering our prayers.  You have helped our family through the darkest moments in our lives.  I remember in one of my first emails I used the phrase, it takes a village to raise a child.  You have been Nathan’s village who have faithfully stood by our side in prayer every step of the way.  God is hearing you all. We know he will protect our Nathan and give his body the strength it needs to continue fighting.  He knows Nathan’s body is tired and needs a break. He knows mom and dad need a break as well.  We do what we have to do and often times ignore the reality because it is just too hard to accept.  Today is not dark, it is not heavy, is it not hard. Today is a perfect day.  it is the first time in three years we feel peace.

Over the next three months Nathan will have a chance to enjoy the sun and play outside with the other children.  He will get to run in the ocean and play with his trucks.  Unfortunately, so many of the children we see every other week at the oncology clinic will not have that same opportunity.  Some of them may not make it through the summer.  That is the true reality of what we are surrounded by on a regular basis.  During this time off treatment, we will direct our prayers to those children who desperately need Nathan’s powerful village of prayers.  They need us.  

We know we still have a very long road ahead of us and Nathan’s journey to a cure is far from over, but today we celebrate this break.  We thank God for giving us the opportunity to feel this genuine peace and joy.

May God bless all of you.  Thank you for loving our Nathan and taking care of our family.  We will be forever grateful for all you have done for us.  Enjoy a relaxing summer!  If you have some time, come join us as we party in the sun chemo free!!!

Love,

Mike, Beth, Nathan, and Samuel

Nathan and Samuel waiting for his MRI

Thumbs up to being chemo free!