Avery's Story
Written by Shara Moskowitz
Avery, my daughter, was diagnosed with cancer on August 8, 1013. She was three years of age. Avery enjoyed going to the library, Gymboree, crafts, playing with friends etc.
On August 8, 2013, Avery was taken to her pediatrician because for the prior month she was not feeling well. I finally asked the doctor to do some blood work on her. He sent us for an ultrasound, then they asked us to return to his office. He informed us that Avery had cancer and to take her to the hospital right away.
The doctors told us they believed it was Wilms tumor. So we were told that she would be losing a kidney and that hopefully they can remove all of the cancer. Several hours after admission as a patient, examined by several other positions, subjected to numerous tests, forced to ingest medication, everyone finally agreed her cancer was indeed Wilms tumor, and surgery was scheduled.
Avery was prepped for surgery, and an hour and a half later into a five hour procedure the surgeon came out of the operating room to inform us that after opening Avery up, they realized that Avery did not have Wilms tumor. Avery had stage 4 neuroblastoma. At this time they only inserted a double lumen broviac into her chest.
Over the next five months Avery endured many hospital stays, fevers (105), sour belly, shots, allergic reactions, blood draws, blood and platelets transfusions, brovic dressing changes, daily cleanings/flushes of her port, medications and five rounds of chemotherapy.
Photo Courtesy of Avery and her Bravery
Photo Courtesy of Avery and her Bravery
Avery is an amazing little fighter. A rundown of her treatment thus far has been:
Double Lumen Broviac inserted into her chest. 3 separate pic lines in her arm. Five rounds of chemotherapy. Losing her hair two times. After the second round of chemotherapy, Avery got something called aphersis. This is where they harvested her own stem cells that she could get back after they were cleaned in her course of treatment. They were amazed when they retrieved 65 million stem cells from our little superstar. Their goal was 10 million. Luckily, extra vials will be stored for her until she reaches 18 years of age. She had a 7 1/2 hour surgery, and resection of the tumor. In addition, they discovered and did corrective surgery of malrotation of the bowels, removed her Appendix and were able to removal 90-95% of the cancer, the remainder was attached to all of her organs. At this point the risk to remove any more outweighed the benefit, as Avery started bleeding so they closed her up.
Unfortunately, that only lasted three days. This is when my world started crumbling once again. My oncologist called me with such sorrow in her voice. I knew something was not right. We got our second results from a different hospital back. A secondary hospital, the Children's Hospital of Philadelphia, known as chop, called us to inform us that Avery was not an NED. She had full body cancer in her skull, entire spine, shoulder blades, upper arms, full pelvis, thighs, and in her bone marrow. Thank God for second opinions. I recommend everyone get one.
At the first hospital, the radiologist reading her scans said he only looked at the first one, and it was clear, and he never looked at any of her other ones. A hard lesson learned. I went to the hospital and forced them to change policy so this would never happen again to another child. Now all oncologists must read their patients scans after a radiologist reads the scans.
After this, Avery received two rounds and MIBG therapy. This is full body IV radiation for 7 days. The hardest part was being kept behind lead walls where she could not be touched or held by me. My heart hurt. Every time she asked for me to please hold her, "Mommy can you come to me?" all I could do was say I can touch you for a brief second and from over the little wall. My little tiny couldn't understand why mommy or pop-pop had to wear gloves and a gown to be in a room with her. She was scared. As a result of these therapies, her thyroid is completely useless. She will be on medication for the rest of her life for that. When she got home as well, she was not allowed to eat on regular plates. Everything had to be disposable. All her stuff had to be washed twice and not mixed with anybody else's. We had to get a doctors note from the hospital for radioactive material being thrown out in the garbage. This is because she was still wearing pull-up diapers at the time. She couldn't sit next to or on anyone's laps. Still, she felt the comfort of being home but not the love of contact for two more weeks.
We hoped and prayed that she would be cancer free after this therapy. We were disappointed, yet hopeful that she would become cancer free soon. Next, she received a stem cell rescue at CHOP. Some call it a transplant, the doctors call it a rescue because it's rescuing her life. She would receive five days of high-powered, different types of chemotherapy at the same time to wipe her whole immunity out of her body. This is where Avery received her own stem cells back that they harvested earlier on. This also means now that her unity will be fresh and brand-new like a baby, she needs to receive all her immunization shots all over again, after 100 days from transplant. For a stem cell rescue you're usually in the hospital for a total of three weeks to a month. As a result of this procedure my daughter developed a complication called venoclusive disease (VOD). This is what occurs when small veins in the liver become obstructed, causing blood clots. This was life-threatening.
Photo Courtesy of Avery and her Bravery
Photo Courtesy of Avery and her Bravery
She ended up in the ICU, and had to get a drain inserted into her stomach to help alleviate some of the fluid. It was touch and go for about a week. She was hooked up to oxygen and had 4 different IV's. They could not get the drain to stop the abundance of fluid leaking out. She had to get about 6-7 painful dressing changes daily. Avery had to endure a lengthy two months stay at chop, and managed to fight her way back. The doctors were fearful for her life on many occasions. During this stay she was not allowed to have hardly any visitors. We were able to at least get out for an hour or two a day in the private playroom still with no other kids. We washed everything that touched her every single day, including all her stuffed animals and blankets, clothing etc. Her's and mine. Thank God I was able to get multiples of Ariel, Lilo and Stitch. We watched a lot of Disney movies. After these two months we were able to both say most of the movies verbatim.
Following the stem cell rescue, Avery received 20 rounds of proton radiation treatments at chop. The hard part about this is that she needed to be sedated daily for multiple weeks in a row.
She then completed 6 rounds of immunotherapy. Immunotherapy was excruciatingly painful. My daughter's hospital stays were two times each month for about five days a piece. Sometimes longer because of the massive side effects.
During these treatments Avery suffered with intense pain, allergic reactions, 105 fevers, abnormal body and organ functions. As a result she needed to be put on high blood pressure medications due to the complications of her kidneys now. The medications she had to take at home are horrendous in every sense of the word. Avery experiences burning in her mouth, lips that crack and bleed, her nails peeled and her skin on hands, face and feet cracked. The medication makes her photosensitive, have drastic mood swings, and causes pain in other areas of her body. However, without this therapy it would decrease Avery's chance of survival. One of the medications was called Accutane.
This super brave child has been subjected to multiple CAT scans, several double bone marrow biopsy's and MIBG scans every three months for a long time. Thank God now she is considered NED (no evidence of disease). She continued to have to go for routine scans every 4 months, then 6 months, then yearly. Now, they have her in the survivor clinic. She goes to Children's Hospital Philadelphia once a year for 7-9 hours of back to back doctors. It's a very draining and emotional day.
The long-term side effects thus far from her cancer treatments are: organ damage, infertility, stunted growth, nerve pain daily, gets tired easily and can't keep up with her friends, joint pain, spinal wedging, cataracts in both eyes, breakdown of her teeth and permanent hearing loss. As I mentioned before, her teeth wound up with a large amount of work. She had 7 root canals, 8 stainless steel caps, 4 white caps, 12 cavities and 1 removal. She has tiny tattoos all over her body that are permanent from where they had to do the laser proton radiation therapy.
Avery must now wear hearing aids in both ears that she gripes wearing every day. She has permanent kidney damage. One shrunk to 25% and the other one is 85%. They believe that two smaller one's will continue to shrink and will result in removal in the future.
We also donated her tumor to science. Thankfully, we did this because in their research they found out that she had the colon cancer gene. Her body mutated itself before she was born. Neither my husband or I have this gene thank God. So at age 12 we will be going for preventative treatment of care for colon cancer. There are 10 types of colon cancer. Ten is the worst, she has number nine. Avery will have several thousand polyps that will have to be removed over a lifetime. We will yet again overcome!
Photo Courtesy of Avery and her Bravery
Despite all she has gone through, Avery is an amazing, loving and giving child. If she saw or heard another child upset or crying, she would say, "mommy can we please give them one of my toys or stickers to make them happier?" The funny thing is she gave all her brand-new toys that she just got as a way to make them happier. She was known on the floors as the sticker and toy girl because she always gave out stickers to everybody every day.
My daughter Avery is a gift from God, to us, and everyone she meets. She always brings a smile to the face of anyone who meets her. She has taught me so much. How to persevere, live in the moment, and love on a deeper level. Fortunately, through an unfortunate circumstance, this experience with my daughter has renewed my faith in humanity. There are so many selfless people out there in this world that love to just give and not ask anything in return.
Now her wish is to give back to foundations that have touched our family and especially Neuroblastoma research. She understands that with continued research, they will be able to continue finding new medications that will help her friends and other children stay alive.
Photo Courtesy of Avery and her Bravery
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