How well you've done so far

Dear Madeline,

It's been almost 2 weeks since I last wrote to you. It's not for a lack of wanting. Rather, you've really been ruling the roost lately. Between your teething pain that's been keeping you up all hours of the night and my getting back to work, I really haven't been bringing my "A game."

Last week we marked your 9-month birthday, and as your present to Mom and I you tolerated your chemotherapy remarkably well. We really didn't see the same sort of downside I've come to expect. Maybe the pain of your new teeth pushing down on your gums helped to distract you from how bad you would have otherwise felt after chemo. Still, your smiles and desire to have things your way shone on through. You played on the floor, hung out in your walker and generally remained in a decent mood for most of the week. Except until the sun went down. Then it was a different story entirely.

Changes ahead

Dear Madeline,

Well, that was quite the long day, wasn’t it? I think we managed to arrive at the Johns Hopkins at about 7:30 this morning for your morning radiation treatment and didn’t manage to get home after your pediatric oncology hospital clinic appointment until about 4 this afternoon. In between, though, we did skip out of the hospital and I gave you and Mom the grand tour of Baltimore to pass the time. (I think we managed to pass through the majority of notable places, hot ZIP codes and wastelands alike.)

You haven’t been taking too kindly to these morning radiation appointments and the accompanying restriction on not eating after midnight the night before. The radiation oncology team needs you under anesthesia so you don’t wiggle around or change positions while receiving the radiation. Trust me, it is better this way. That doesn’t mitigate the perverse irony, though, in that the intentional damage to the area where your giant tumor was is triggering your body’s healing response, which in turn requires a great deal of energy (and thus, a great deal of eating to fuel the healing). Your treatment is, in short, making you very hungry and we need to deny you some of your feedings in order to ensure your treatments are as effective as billed.

... it all seems to fit together. If only we knew to look sooner.

Dear Madeline,

In your brief 7 months of life, you've managed to humble your old man on a daily basis. From the date of your birth to this morning, I've felt challenged by you and rewarded for the effort. We've shared sleepless nights, we've had our fights, and we've worn each other down into submission. Your mom and I often looked at each other in astonishment and defeat, wondering why your first months have been so difficult for such a young baby, especially given your more recent instances of spitting up almost the entire quantity of any amount of bottle you consumed, loss of appetite, intolerance of sitting up and laying on your back for anything more than a few minutes, and general crabbiness.

Last week, you developed an ear infection and, a few days later, you began your first course of antibiotics to treat it (even if the pharmacy forgot to add the compounding liquid to the powder). That gave you some brief relief from Monday night into Thursday morning. Then your mom noticed an odd reaction in your foot: redness, swelling, it was hot to the touch. We wondered if it was an allergic reaction. Just after Mom set up an appointment for you with the pediatrician for the next morning, you presented your first blood-stained diaper.