New places and old places...

It ended up being a nice day today, so we went to the zoo with our friend Aimee. We got to see several animals, but Alan was far more interested in the grade school kids that were at the zoo for a field trip. He wanted to be a part of their group so much, he even lined up with them at the petting zoo when they were getting ready to leave. Also, while in the antelope area, a couple of them looked like they were about to fight (they started clashing horns). Several of the boys started chanting 'Fight! Fight! Fight!'... guess who joined in the chanting?

Daddy even helped Alan be a prairie dog, with Mommy playing 'Whack a Mole' trying to get a picture of Alan poking his head out of the kids 'tunnels'. I think Mommy got one picture out of several attempts..

After lunch, we went to MD Anderson for two consults, one with a new Doc H, a pediatric oncologist similar in medical discipline to Doc P and Doc A back in San Antonio. Our consult with him revealed nothing new... it was mainly a formality so that all surgical patients have been seen by one of their oncologists. Something interesting we found out was that infantile fibrosarcoma has a specific genetic marker that can be tested for. That marker was tested for and found to be not present in the original biopsy and the tumor taken out during the surgery in January, confirming that this isn't infantile fibrosarcoma, but undifferentiated sarcoma. In general, this does not the change the overall treatment plan (surgical resection).

Our second consult was with Doc L, a sort of final 'in person' consult prior to surgery. In some ways, this was revisiting old territory explored one year ago. In short, based on the original pathology (before any chemo was started), and a look at the latest CT and MRI scan from September and radiologist report, shows that the tumor is still originating at the hip bone area. She has shared Alan's images and consulted with many other doctors, including her mentor in Boston. They want to be absolutely sure they get everything. Alan has already had a recurrence and we don't want to risk another one.

The operation is planned to be a type one and two internal hemipelvectomy, which means removal of the right hip, and fusion of the right leg femur to the remaining portion of the hip on that side. Alan will lose that hip joint, requiring a spica hip cast for 6 weeks... 3 weeks in-patient in the hospital. We will come back to Houston in mid-January to remove the cast and then every three months after that for follow-ups until she feels confident enough to hand the follow-ups over to a doctor in San Antonio.

Obviously, this isn't what we wanted to hear, but at the same time, it was not completely unexpected. We are no worse off then we were at this time last year and are trying to look at it as Alan getting an additional year of full mobility from the time this option was originally brought up until now. We finished up by going over some of the details for next week, trying to keep the model of the hip bone that Doc L had brought in to show us what she planned out of Alan's reach. For some reason, he decided it looked like a gigantic chip or cookie and wouldn't stop trying to take a bite out of it. Doc L's PA had to get Alan some lollipops. It was a nice light moment.

We are going to get him out and about this weekend and trust that his unstoppable spirit will keep him going.


Alan in the goat enclosure with the big boys

Alan playing gopher

Alan playing in the backyard at RMHH after the hospital

Alan had a great time on the slide