Bottoming Out / Pre-School Graduation Day

As we often mention, the community support we've received during the last 8 months has been a perpetual source of love and gratitude.  Today, we would like to give a very special thank you to The Academy of McKay's Mill.  The Class of 2018 is graduating tonight, and we really wish Caroline could be there in her little cap and gown, just like her friends, and just like her brother, when he graduated from The Academy in 2013.  The Academy is where Caroline spent every working weekday since she was 16 weeks old...it was her home away from home, and she loved her teachers and friends just like they were her family.  Other than telling Caroline she had cancer, telling her she couldn't go back to school and see her friends/teachers was the hardest conversation we've had with her.  Although Caroline never went back to school after she was diagnosed, we've never felt like she actually "left."  Our Academy family has been steadfast in their inclusion and support for Caroline - always checking on her, sending cards, videos and even homework!  We were also included in the formal graduation photos, and then were surprised with a special insert for Caroline within the graduation program, which literally brought us to tears.  Despite the fact that Caroline won't be able to formally graduate with her friends, having a picture of her in a little cap and gown, from a place that helped raise her, is truly priceless.  Thank you, Academy of McKay's Mill - we love you all!     

Hospital Update:
Right now, Caroline is having her most difficult stretch since starting the treatment protocol back in November.  She has extreme mucositis through her entire GI tract (worse than during her last transplant), which is causing her to struggle with getting enough oxygen.  She is now on a nasal cannula, which is giving her the oxygen assistance she needs.  The other major issue she's having is blood and intestinal tissue in her stool, also as a result of her GI tract being stripped raw from the high-dose chemo.  Needless to say, it is VERY painful for her; she is on continuous Dilaudid/pain medication (already more than the last transplant), as well as a patient-controlled button, which she needs to use frequently.  The mucositis has also moved into her throat, which causes her so much discomfort that she doesn't want to talk; she is mostly using hand motions and a bell to get our attention.  We expect her to struggle like this -- or worse -- for the next 5-7 days.  She received both red blood and platelet transfusions today to help get her numbers up before we head into [what we expect to be] a very challenging weekend.  Please continue to pray for her comfort and a speedy recovery.

Team Lantz
#carolinestrong
#ftgf

Rough Weekend / Stem Cell Transplant

We've had a very difficult few days.  The side effects of the high-dose chemo kicked in much quicker this round, compared to the last.  Caroline has been dealing with:

• high fever
• diarrhea with blood in stool (result of colitis and mucositis, as determined by an unplanned X-Ray and CT Scan late Sunday night to confirm)
• colitis
• musocitis
• nausea/vomiting
• loss of appetite (she hasn't eaten since Thursday, and is getting all nutrition through an IV) 
• severe abdominal pain
• leg pain

Although the transplant/oncology team warned us that this transplant would be harder than the first, we were not really prepared for how badly it would get, and how quickly...and we haven't even seen the worst of it yet.  Caroline is already on a Dilaudid PCA, which is administering continuous pain medication, as well as countless other medications, scheduled around the clock.  Other than the actual diagnosis, these have been the hardest few days since November 2017, when she began her treatment protocol.  As of today, she officially does not have any white blood cells or ANC/neutrofils (immune system), which is why we expect her condition to worsen over the next 7-14 days, before it should begin to recover from this awful stretch.

Around noon today, Caroline received her 2nd stem cell transplant.  The stem cell transplant helps her body rescue itself from the high-dose chemo.  Without this rescue, she would not be able to recover from the high-dose chemo.  The process itself, as mentioned in the post about the 1st stem cell transplant back in May, is very anti-climactic...the frozen cells are brought to her room and thawed bedside, inserted into a syringe, and slowly pushed through her central line over about 15 minutes.  The process is not painful, but it does smell like creamed corn in the room for a couple days, which is weird.

As always, the hospital staff does an amazing job of explaining every process to Caroline, and is always looking for ways to make her comfortable and happy.  Transplant day is a very big deal around here, so they really do it up!  She got signs, toys, and music therapy during the whole process...it really made her smile, which always makes everything easier to watch.  Words do not do justice to the love and kindness that is shown to Caroline and our family every time we're at Vanderbilt; this place, and more importantly...the people, are truly amazing!

Thank you for your continued prayers, specifically for her comfort during the next week, and our family's emotional state.  This just plain old sucks.

Hanging in there,

The Lantz Family

#carolinestrong

#ftgf  

Rough weekend.

Full-service bed ride to CT Scan. 

CT Scan

Awesome door sign made by Child Life Services volunteers!

Caroline's own stem cells to the rescue!

Actual stem cell transplant.

Daddy and Caroline with one of her favorite gifts in the bag today...a blow-up Unicorn head...LOL!

Chemo Complete! (Hopefully FOREVER!)

Today was the last day of chemo for this round (and hopefully ever!)!!!

So far, Caroline has been in pretty good spirits...she is still eating and drinking a little bit, playing with slime, doing art, and even got out of bed to do some music therapy.  Nausea, vomiting and diarrhea are currently her biggest side effects, so she is on a few medications to help with those.  We expect the next few days to get progressively worse, as her body continues to react to the high-dose chemo.  Although she is eating a little, the doctors have started Caroline on some nutritional supplements via an IV line and her NG tube.  The next big step is the stem cell transplant, which is scheduled for Monday, followed by approximately 3 weeks of inpatient recovery (again, due to the high-dose chemo side effects).

Andrew is currently enjoying 2 weeks of fun on vacation in Baltimore with family. Yesterday, thanks to a very generous friend, he got to attend Day 1 of Ravens Training Camp 2018.  He had a blast and got so many collectibles, which he said he wants to share with his little sister when he returns!

Mom and dad don't sleep very much these days...we're still struggling to deal with all of this mentally - the long and exhausting treatment protocol, what's still ahead, and being separated from each other constantly.  That being said, we cannot express enough how much we appreciate the visits, outreach, love and support from our friends and family.  We are very thankful we don't have to go through this alone...Caroline and her army of supporters are strong, so we must stay focused on that, even though it's easier said than done.

Team Lantz
#carolinestrong
#ftgf

Goofy time with music therapy.

 Training camp with Pop-Pop.

Cousin fun!

Thank you, MP, for always decorating Caroline's room every time we've been admitted...we love you!

Day 1: High-Dose Chemo

Today at 7am, we were admitted for Caroline's first day of high-dose chemo.  We had a very stressful and adventurous start to the day...to summarize:

1. Last night, we got a call that Friday's echo-cardiogram showed that her central line may have moved internally, and would require an early morning X-ray to confirm; if it had moved, it would require surgery to repair.  Caroline wasn't able to eat/drink after midnight last night, just in case.  We were extremely worried about her having to endure another surgical procedure right before high-dose chemo, which is already rough enough.  Thankfully, the X-ray showed that all is normal, and we were able to start chemo on time.
2. Unrelated to the scare above, during the first full hour of chemo, we noticed that Caroline's central line was leaking blood onto her bed.  We immediately called the nurses. ..they paused her chemo, and moved both chemos to one line.  They found a cut in her left-side line, and luckily, the surgery team was able to fix it bedside...fascinating to watch (kind of like fix-a-flat tire patch, with super glue).
3. FUN NEWS: Caroline lost her first tooth today at exactly 2:30pm (aka: toof hurty...haha...dad joke)!!!  She was so proud and excited, and has been telling anyone and everyone that passes by!

Caroline will receive 3 different types of chemo for the next 3 days, and then 2 types of chemo on the 4th day (Thursday), followed by a stem cell transplant on Monday (7/23).  We expect to be here for the next 30 days or so, recovering from this sub-lethal dose of chemo.

Thank you very much to everyone that donated Postmates gift cards for hospital meals - they are a huge help!  We appreciate all of the generosity and prayers you've sent our way!

Much Love,
The Lantz Family
#carolinestrong #ftgf

Chemo cocktail...

 Waiting for the X-Ray

Hug the X-Ray Machine!

Slice in central line.

Bedside line repair.

Playing babies while getting chemo!

Lost her 1st Tooth!!!

Next Steps / Family Meals

Caroline's "at home break" in between treatments is coming to an end.  She will be admitted on Monday (7/16), for the second round of high-dose chemo, and a second stem cell transplant.  We expect to be inpatient at the hospital for about 4 weeks straight, most of which will just be recovery from the 4 days of high-dose chemo.  The expected side effects include: high fever, loss of appetite, mucositis, vomiting, diarrhea, possible rash, fatigue, etc.  Caroline will begin this inpatient stay on isolation and contact precautions because she is still testing positive for the "rhino virus" (aka: common cold).  It will (once again) be a very difficult stretch for Caroline, and our entire family.  Please continue to keep us in your daily prayers.

Here is the remaining approximate treatment timeline:

• Inpatient High-Dose Chemo / Stem Cell Transplant (1 month)
• Rest-at-Home Break (2-3 weeks)
• Outpatient Radiation (3 weeks)
• Inpatient and Outpatient Immunotherapy (6 months)

Assuming there are no setbacks, the above treatment plan runs through April 2019.  

We have decided to not post any at-home delivery meal train dates for the upcoming hospital stay, since most of our time will be spent at Vanderbilt.  However, if you would like to donate a meal, please click here and you will be directed to Postmates gift card page.  You can send the gift card to Margaret's email (margaretlantz@gmail.com).  It is a very convenient option for us to get dinner delivered from a restaurant close to the hospital, and saves us from eating in the limited food court all the time...

Thank you all for the continued love and support!

Lantz Crew

#carolinestrong #ftgf 

Learning how to sew with her godmother, Kathleen!

Happy 5th Birthday, Caroline!

Happy 5th Birthday to our sweet Caroline!

She's feeling pretty well, and is having a great birthday weekend.  To commemorate the special day, we had our family picture taken this morning (thanks, Anna, for the pics and insanely quick turnaround!)...here are some of our favorites:

Thank you for your continued prayers and support for our family...and here's to many more birthdays to come!

Team Lantz
#carolinestrong
#ftgf

Autumn Jones' Fundraiser for Caroline / Clinic Visit Update

Thank you to everyone who participated in the Caroline STRONG fundraiser last night!  We had a great turnout, and we were truly blown away by the love and support from all of our Franklin-area friends and neighbors.  Caroline had a wonderful time seeing so many of her buddies, including her new pal, the Predators mascot, Gnash (major props Brian and Lincoln!). 

An extra special thank you to Autumn Jones for creating and organizing the entire event!  She put a ton of work and effort into this and we are beyond grateful for her dedication from start to finish.  Autumn, you rock and we love you! (*Fun fact: Autumn hosted Margaret's baby shower for Caroline back in 2013*). 

We also want to give a shout out to Autumn's VP's of Party-Planning, Cris Smith and Elizabeth Regas, and to all of the other folks that worked the raffles, check-in, kids' tables, grills (pretty much all the Jeffs in the VOC), DJ booth, dance judges, auctioneers, etc...we appreciate every one of the volunteers.  It was a night we will remember forever!  Our hearts are full and y'all are amazing!

Caroline visited the VUMC outpatient clinic today for her regular check-up, and (finally!) got mostly positive news.  Her platelets, white blood cells, and ANC (immune system) counts were all strong!!!  However, she did require a red blood cell transfusion as a result of low hemoglobin numbers. The doctors seem pleased with her recovery progress, so as of now, we are on track to start Round 2 of High-Dose Chemo / Stem Cell Transplant on July 16th.  Please continue to pray that Caroline stays healthy (and happy) over the next few weeks to avoid any delays in the treatment protocol/timeline!

As parents, we are very sad many days, really do struggle to get through the day, but you folks help keep us moving forward.  So, once again, thank you for all of the love, support, prayers, and well-wishes from near and far.  We could not do this without our incredible, ongoing support system.

Team Lantz

#carolinestrong
#ftgf

First time on a swing in almost 2 months!

FREEZE Dance!

Meeting Gnash!

Sporting her Gnash gear for clinic...

Cracking herself up while getting her blood transfusion - LOL!

Looks good...but, counts are LOW :-(

After 10 days home, we're finally settling in and getting back to our routine...for now.

Caroline went to clinic this past Monday and again today.  Her coloring is great, she's been acting more like herself, but her insides are still really fighting hard to recover from the high-dose chemo.  Her ANC/Neutrofils/White Blood Cell "counts" are still really low.  In fact, if we were inpatient right now, they would not even be high enough for her to be discharged.  Luckily, she doesn't have a fever, so we're able to continue to recover at home.  Caroline will remain in isolation (at home) until her counts come up...which we're hoping happens this weekend.  She got another Neupogen shot today, which is her 19th Neupogen shot since she finished the high-dose chemo right before her stem cell transplant.  Just as a refresh, the Neupogen shot helps revv up her white blood cell count, but her body is just taking a longer time to recover.  We return to clinic on Monday to check again.

Thank you for the continued prayers, meals, gift cards, generous gifts...everything!  Thank you for sticking with us through this long, hard journey. 

Reminder, if you're local, we'd love to see you next Thursday (6/28), at the event our awesome friend Autumn is hosting!  Click here to purchase tickets.  Hope to see you there!

Happy Father's Day

Happy Father's Day to the most amazing dad I know...Mark!  He's getting our family though the toughest time I hope we ever face.  We're so lucky to have you as our protector and provider, and we love you so much!

XOXO - Margaret, Andrew, Caroline and Hank the Tank

Reunited...and it feels so good...

We're all home and under one roof!!! 

Thank you for lifting up so many prayers!
Team Lantz
#carolinestrong
#ftgf

Besties!

Still here...

We have spent 27 of the last 28 nights at the hospital, and it looks like we are here for at least 1 additional night (maybe more).  Caroline needs to be fever-free for the next 24 hours, maintain good blood and platelet counts, and be eating and drinking enough on her own before they will consider her for discharge.  She is in good spirits, and her appetite is returning a bit, so we are cautiously optimistic. Please continue to pray for progress with recovery so we can get home ASAP!

Family Fun Party ticket link below-  Thank you for all the support!

https://www.eventbrite.com/e/carolinestrong-party-fundraiser-tickets-46769774655

Team Lantz
#carolinestrong
#ftgt

Eat More Cake!

A Better Day / Local Fundraiser

Caroline’s fever looks like it has finally broken (hope this doesn't jinx it!)!  She has been fever-free since 7am this morning, and we're so grateful for the improvement.

She does have a little fluid retention /swelling as a result of some of the treatments she's received, but it doesn't seem to be a major concern at this time.  We are also monitoring a new, mild body rash that seems to be spreading, with no clear indication of the cause (yet).  Luckily, it's not currently itching her, but it is a concern that we will monitor and hope for a resolution ASAP.

The Vandy team started Caroline back on her NG tube feeds this afternoon - she will slowly increase the dose until she is able to tolerate at least 75% of her nutritional needs; she will continue these feedings at home (whenever we get back there) until she can/does eat proper nutrition on her own. The high-dose chemo and mucositis really effected her GI tract, and she hasn't wanted to eat or drink much at all over the past few weeks.  She is also able to take her oral medications through the NG tube, which is a huge help while she's still recovering from the pain of mucositis.

We expect to be in the hospital at least a couple more days, or until she is "healthy" enough to return home.

Local Nashville friends: please click the link below to check out this awesome family fun event that Autumn Jones has put together to honor Caroline. Thank you very much, AJ, and all of the supporters!

https://www.eventbrite.com/e/carolinestrong-party-fundraiser-tickets-46769774655?ref=eios&aff=eios

Many Thanks!
Team Lantz
#carolinestrong
#ftgf

Thank you for sharing your unicorn cookies, Arlie!

Back in the Hospital

After less than 12 hours home, Caroline was re-admitted to Vanderbilt very early this morning due to severe nausea and a high fever last night.  Many tests and an x-ray later, they've determined she has some kind of virus (rhinovirus or enterovirus), which essentially is the common cold.  With her weakened immune system, all viruses and infections (and their symptoms) are cause for alarm and need to be addressed immediately.  For now, she will be resting in the hospital, getting hydration/nutrition and fever control. We are awaiting the results of a couple more tests, but hopefully we are able to go home again in the next couple of days; we will keep everyone posted.

The Lantz Family

#carolinestrong

#ftgf

22 Days

After 22 days in the hospital, we're out!

#carolinestrong

#ftgf

She's turned the corner/Angel Nurses

Today, Caroline's ANC (absolute neutrophil count/immune system) was up to 750, which is great progress, considering she has been at 0 (zero) for a long stretch!  Among other things, she needs to have an ANC above 500 for 3 days in a row to be considered for discharge.  She is still on a laundry list of medications, and a little swollen from fluid retention, but barring any setbacks, we are on pace to go home Monday...1 week ahead of schedule!  We are VERY excited to all be together again in the same house!

Caroline will come home with her feeding tube for at least 4 days, or until she is getting enough nutrition through her regular diet.  We should be able to enjoy 5 weeks at home before the next round of high-dose chemo/stem cell transplant #2 (more details to follow, as we get them).

Once again, thank you to all the doctors, nurses and support staff at Vanderbilt!  Caroline is having a great time this week hanging with many of her nurse friends: Morgan, Josee, Abby, Deanna, Valerie, Ashley, Livvy, Jennifer, Caitlin, Sarah, Kate (welcome home!!!), and so many more...we are so blessed and grateful to have such wonderful people taking care of our daughter!

Thank you for all the prayers and support!

The Lantz Family
#carolinestrong
#ftgf

Arts and crafts with Nona!

Mucositis Pain / C. Diff / Rash Update / Fever

Caroline is still in really rough shape overall.  She has severe pain from the mucositis that has spread throughout her GI tract, which is a major side effect of the high-dose chemo and not having an ANC (immune system).  She is also still struggling with the pain and effects of C. Diff, which she will be tested for weekly, until she tests negative for the infection 2 weeks in a row.  Her pain is being managed by both a continuous morphine drip and a demand push-button.  She's also been fighting off a fever for the last few days.  We are grateful that Caroline is no longer dealing with the rash that lasted for 7 days, and she has not complained about any severe itching for the past several days.  Her day primarily consists of laying in bed, with an occasional trip to the couch to play with her baby dolls.

We are hoping that she begins to turn the corner over the next several days.  The first indicators will be an improved ANC, and less pain in her mouth/throat and GI tract.  She has not been able to eat or drink in over a week, but is receiving nutrition through her NG feeding tube and IV fluids.

Thank you for all the love and support!

Lantz Family
#carolinestrong
#ftgf

Changing the lines/IV bags...so many medications hooked up at once.

How she spends most of the day.

Peach fuzz hair will fall out again from this round of chemo.

Morphine push button.

She loves playing babies with Aunt Joanna!

Always trying to smile, no matter how she feels!