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What's your boys name, age and type of cancer?
His name is Nick Fiorito, he is now
fifteen and a half, he actually just had his half birthday
He was diagnosed when he was 12.
Hi cancer is
T-Cell Lymphoblastic Lymphoma.
Given the cell
type, "T-cell",
it's closer to ALL (Acute Lymphoblastic Leukemia)
It's classified as a Non-Hodgkins Lymphoma,
but it's actually closer to an ALL than to Hodgkins disease, from what I understand.
How rare is it?
It's not that rare.
It's one of the more common cancers at Sloan (Memorial Sloan Kettering Cancer Center in New York)
But in the world?
Well, obviousley
all pediatric cancers are rare,
but it's definitely one of the more common ones
It's more common with boys,
in teen age boys it's most common.
He is the youngest
that we have met at Sloan (Memorial Sloan Kettering Cancer Center),
the youngest boy that has it.
We only met one girl diagnosed with this disease.
Nick was in the beginning of 6th grade, so
he was eleven and a half,
and for a couple of months he kept
coughing, and telling me he was having trouble breathing, and I took him to the
doctor and they thought maybe he had
Bronchitis.
they had him on Antibiotics and that didn't work. I brought him back to the doctor again
and they put him on inhaler.
They thought it was maybe Asthma.
I called the doctor and the doctor was actually getting annoyed with me
because I kept pestering her. I thought there was maybe something more to this.
She actually got angry at my son because he wasn't using his inhaler
properly
which now that I have been in nursing school
one of the things that was happening which i was not aware of is a lot of fluids
kept building up around the heart and lungs
and the doctor really should have been able to hear the fluid build up, heart and lung sounds, which she didn't pick up
She should have been able to assess when he used the inhaler that it wasn't working. Usually when you use an inhaler it does work pretty quickly
It wasn't working at all
anyway finally in February, since started I guess in
October/November, by February we said we need to have a
chest x-ray done. Immediately we
were sent to the emergency room for a chest x-ray
It was obvious very quickly to the Emergency Room doctor that
this wasn't just nothing, that this was something
and they didn't want to label it anything yet, and very quickly it became apparent to me that this was something serious.
They did a chest x-ray
and then they did a
CAT scan, and his
entire upper body was cancer.
At the time they called it Leukemia. They didn't know how to classify it.
We were sent to
Morristown memorial hospital
from the emergency room in Summit
where they
confirmed that it was T-Cell Lymphoblastic Lymphoma.
There was so much fluid buildup around
his heart and lungs
they had to do an emergency surgery to remove it
and we were just uncomfortable having it done there.
I've had experiences at Sloan before
and just decided that if I'm going to deal with cancer, I want my son to be at Sloan.
They rushed him by Ambulance that night, at 10:00 at night into Sloan,
where he was met by a doctor
Dr (Michael) LaQuaglia
who, thank god, he was there. They performed surgery. I met with Dr. (Peter) Steinherz.
They explained to me what we were
focusing on. They actually told me he might not come off the table.
Because his
the tumor was so large it was compressing his Trachea. The Trachea is (supposed to be) round but
it was compressed like this.
They could not give him any anesthesia
any sedation, nothing! They were concerned he would
go under respiratory distress on the table.
They did the surgery with nothing!
They had to have doctors and nurses holding him down
They had to go in and around his heart, and his lungs, and remove all the fluids.
Thank god he survived that. With No anesthesia? Nothing!
Tubes going into his chest,
going all around. His heart and lungs were nothing.
actually the anesthesiologist
came to his bedside the next day crying, and said that
in all her years at Sloan she never had to put a child through what she had to put him through that night.
They started a round of Chemotherapy that night. That's how our story began. We were in the children's PACU (Post-Anesthesia Care Unit) for a week.
We started on what's called the "New York 2A" protocol. It's a 2-year treatment.
They use it for ALL (Acute Lymphoblastic Leukemia) and for T-Cell Lymphoblastic Lymphoma.
For how long have you been under treatment?
He was treated from
February 2010 through April 2012. Now he is 14 months off treatment.
So actually the signs started at September 2009?
I would say that
they started, like the very mild ones, in October probably, 2009.
You ended it in 2012? We ended in April 2012.
When he was declared 'cancer free'?
Actually with Leukemias, they go away very quickly
I like to equate it to
soap-bubbles
they took x-rays on a daily basis, and you could see that
in the peritoneal cavity,
in the whole upper part of his body,
it almost just dissolves and you can watch is dissolving.
It should go away very quickly if you are responding to treatment. I think his was gone within 3 weeks.
Completely gone.
nothing that was detectable.
What type of treatment did he get
other than Chemotherapy and surgery?
He had the surgery to remove the fluid,
the Chemotherapy,
and then he had a cranial radiation because at that point he was a 'stage four'
so he had (cancer) cells that had spread to his spine. Because it was in his spinal cord
they gave him cranial radiation.
Very very mild dose, for 2 weeks, he had 40 seconds a day for 10 days.
You mentioned something about
other medicines that he got?
Other than the drugs, you've mentioned steroids?
Steroids, actually a very high dose of steroids are very toxic to the B-cells and
T-cells so they use it in the Leukemia treatments.
During the chemotherapy? yes.
Well they are considered a chemotherapy.
When they are (given in) such high doses they are considered a chemo.
But steroids are very,
probably of all the chemo that he had, for him they were
the most damaging for the long term.
So he was declared 'cancer free' at early 2012?
Yes, well they never really used the word "cancer free"
the whole "cancer free" is very ambiguous
Even the word "remission" I found they really didn't use
that terminology.
They haven't seen any signs..
They haven't seen any signs
there was no detectable cancer within the first month of the treatment
So now we are in June 2013
how's he doing?
He actually,
a lot of the kids after the induction phase,
The induction phase with the
Leukemia protocols are just brutal.
A lot of the kids there
they become very neutropenic
meaning that all their white blood cell counts are so low and they are very susceptible to infection.
A lot of them are in and out of the hospital because they get other infections along the way.
He in particular
had a much harder time with the treatment than most kids.
His platelets count were low in numerous occasions and also in addition
when they did the surgery he got a blood clot in his femoral vein
so he was on Lovenox injections for the blood clot for two years in addition to chemo.
so he just had a lot more
issues and side effects than most of the kids
so because his platelets were so low during chemo
and being on the Lovenox
he was in very high risk for bleeding.
He would get nosebleeds and we would go inpatient
he would get fever any time he had really low counts. he had fevers
for the first six months he was in-patient
seems like we were two weeks in - two weeks out, two weeks in, two weeks out
So today he is being treated for the side-effects?
Well yes.
The biggest
side-effect, the most long-term
issue, it's Avascular necrosis (also know as AVN or Osteonecrosis) from the steroids.
A lot of the kids get it. Some kids get it in their hips
and the interesting thing about that, the Oncologists
only recently they are saying that they have seen
parents being more
proactive and look to treat it.
In the past they just kind of
watched it heal and they seem pretty confident that it will heal
although they do agree with me that Nick's AVN is significant.
much more significant than anything they have seen in the past
Occasionally they will see it on one joint, maybe an ankle maybe a knee, more often than not a hip
My son has it in
both shoulders, both hips, both knees and both ankles. We are spending a lot of time in Hospital for special surgery now, trying to be proactive. Hoping that it heals to some extent.
Your bones are actually a living tissue
their vascular, they have a blood supply. Avascular Necrosis is
the lost of that blood supply so the bones become very brittle.
The joints breakdown. Instead of having a round joint and a round socket
The bone becomes brittle and it breaks down with use.
It's T-Cell Lymphoblastic Lymphoma. It's different from the B-Cell. From what I understand the T-Cell are a little harder to treat
because T-cells are.. I don't know.. I heard Dr LaQuaglia refers to them as 'tricky T-cells'
It's very similar
more similar
to an ALL (Acute Lymphoblastic Leukemia) to another Hodgkins.
it's classified as Non-Hodgkins
I didn't really looked at a lot of research
I have researched doctors
I wanted to find a doctor with the most experience
and everybody
referred me to Dr. Peter Steinerz at Sloan (MSKCC)
Is it a blood cancer?
Yes. It's a blood cancer.
It's different than Leukemia which is more
in the blood
whereas Lymphoma is more in the Lymph system
which is kind of the waste system
The cells go so crazy that my son had all this fluid built up
that it just starts to interfere with
the body systems
With him it was
compressing his heart
compressing his Trachea
that's what eventually.. if he had died without any treatment, his Trachea would have been compressed and he wouldn't have been able to breath
So the Lymph nodes
just grow?
If you saw it on an x-ray it is almost like a big cloud
it was just taking up space
The Lymph nodes themselves?
well I guess the whole
it wasn't just the Lymph nodes.
I'm not really sure.
is there a tumor to remove? No, there is no tumor to remove.
I you could watch it on an x-ray on a daily basis
it almost dissolves
So the treatment is chemo?
chemo and radiation
if you have a stage three or four,
and it spreads to the spinal column
or the brain, then you need some sort of radiation.
You know i just got on the web and read
every everything that I could read. I can't think of one..
there really aren't a lot of websites. There are really
pediatric cancer sights.
you spend a lot of time on the web. I would get up
everyday
and read everyday for an hour or two everyday.
And there really is no specific website that will give you
there's a lot of articles
and lot of them are so
something that
the medical industry would read.
So it's more like researchers? Yes
There really isn't.
So there's no Facebook group for T-cell?
No. Not that I have found.
So where would a parent find
the most relevant information if he wants to learn about this disease?
other than your story and maybe others,
where would the parent go?
There really isn't. You could comb the web
and I just put it in "T-Cell Lymphoblastic Lymphoma"
and there is not even
I have probably read every single article on the web
ten times each.
and there really is not alot.
And there's not a lot.. I mean you'll see
from 1999 maybe every year one article.
There is not a lot.
You hope to get it from your doctors but unfortunately I find they don't like to
give you too much. because I think they think it scares the parent.
Too much information? Yeah, they give you just enough.
From your knowledge the best doctors and the best hospitals
and the best medical centers
for that specific type of cancer?
Well,
thank Gd I'm in NY and that I did end up at Sloan. I guess if I..
I heard very good things about St. Jude. And also heard good things about children's hospital in Philadelphia (CHOP).
Could you mention specific names of
doctors that you could recommend?
Well I only know Dr. (Peter) Steinherz.
Dr Steinherz would be your recommended, the oncology
your would recommend? Yes.
He also works with Dr (Neerav) Shukla You know when you
work with a team at Sloan
you spend two years with these doctors
like Dr. Peter Steinherz is much more conservative than maybe
his protegees who are Dr. (Neerav) Shukla & Dr. (Rachel) Kobos
So you kind a learn who to go to, for what.
It's nice to have all three of their opinions.
And as a parent you really kinda have to decide what's best for your child
after you get those opinions.
And for me being in uncharted territory, I kinda had to
say 'well I choose this doctor who seemed
to be the best'.
I did have other doctor's name
three years ago but now I have forgotten them.
And for me, I had to say 'well I have chosen this team'.
I kinda have to put my faith in them and hope that they are going to do the right thing.
How many other parents with similar type you've met?
And you probably compared stories etc..
How many similar
patients have you have met?
And from that,
what's your experience about the path you chose?
While I've probably met ten families with this identical diagnosis
a couple of them
did not start start out at Sloan. They started out elsewhere and ended up at Sloan.
they had better outcomes
and more positive experiences at Sloan.
I met actually many families not just with our disease but with other diseases who started elsewhere and wished they had started out at Sloan.
I mean, I think that
what happens in your first month or two of treatment is significant. Yes I agree. In any pediatric cancer.
The first signs where.. and oh Gd
if I only had listened to him that day. As he
told me he was having trouble running. He said 'mom I think I have asthma, I'm having trouble breathing
when I run'.
He really never had a fever.
He didn't have any bruising.
He had none of the typical signs for
these diseases.
He just had,
the closet think I could equate it to would be asthma.
Like a little bit (difficulty breathing) when he breathed.
We have allergies in our family and a lot of
hay fever and a lot of..we just thought it was
allergies. he had a little bit of a runny nose and a cough and his cough got
progressively worse.
Me being in nursing school now
if I had known then what I know now. If I had only been able to use
a stethoscope.
I think i could have heard the fluid build up around his heart and lungs.
Shame on that pediatrician for not detecting it.
Because he had so much fluid built up
I mean his whole heart and lungs were compressed
I mean one of his lungs by the time we got in was actually collapsing. And shame on her for not, I mean
that's one of the first things you learn even in nursing school is how to listen to heart and lung sounds.
So the cough got progressively worse, and the
first thing they did was the chest X-ray, where they could see a cloud.
And then they went to do a CAT-scan
to get a better picture of that cloud.
And then they did blood tests once they were too.. We ended up at
the second hospital
within one day we were at three hospitals.
The emergency room and then Morristown memorial. Where they did
there they did an echocardiogram because they wanted, they knew they had to do surgery
to remove the fluid.
So they were looking at the heart and lungs
to
see what surgery would entail, if they can even do it there.
And then I guess they did blood test, to get the differential.
Although the doctor at Memorial,
because of how it presented, with the
peritoneal cavity.
She, without any blood tests ,she knew right away what it was.
Going back, a parent whose child is
complaining on Asthma-like symptoms,
won't go to an emergency room and have him checked (for cancer), right?
would you have done anything different?
looking back on it, I..
just on the diagnosis part
Well yeah i do wish
that i had insisted on a chest x-ray when he was complaining
but you know i have taken him
to a pediatrician three times
and i have three other kids you know all of whom
had coughs and
i've been in the hospital with pneumonia. I actually thought this is a pneumonia, that this had to be a pneumonia.
My daughters had pneumonia
i thought we will probably need to be in the hospital for a couple of days
I can't really say.. obviously i wish I had listened to him
and I wish I would insisted on a chest x-ray, in hindsight,
but I can't say..
the day he was diagnosed he was at baseball trials, running around
so you know even with all that fluid built up
event with the emergency surgery they told me he might not come off the table that nigh
that morning he was running around
playing baseball
so he was still healthy
he was going to school he didn't miss any school
so he wasn't sick enough that I would really have any way of knowing.
Your first surgery: that was your first encounter
with "the cancer"
And that was like
straight into the fire:
UP UNTIL HERE we want to you and your your boys running on t_v_ it may not come up
went through your mind
dozens of other
what you really need you really
where you're talking to us
no ideally
that's almost a blessing in
even though you meets habit immediately know that it's something
terrible
really just don't know how terrible it is an almost
realizes slowly
and that night
and i really
although i do this is
you know i i was focused on the surgery at this point i wasn't focused on the
cancer because they
he said he may not get off
slot was unavoidable literally mean keep an ambulance for new jersey and they all
the whole team s there at the door at after site
hardly a game
we depressed
prepared to talk with us the sentencing
all the time we needed to ask all questions in that that really work
talking about
whether or not the spoilers
so they did the surgery it enough for retirement
they had to do it too
for the next few days even though they
the treaty doesn't automatically deacon
active several days along
collapsed
congested streets
policy issues
detroit attorney
alternative medicines or attempted treatments jury
now do you really have in this is one thing that i'm
we had a lot about talked a lot of doctors
and i'm just saying excuse very considerate and doesn't
on the trash can
any alternative medicine
citibank inman's and
if you think about it cancer so
is a very
like a regular cell leaves
crazy salary
metabolized
much faster than an animal cell
saint louis
give the body cancer cells in it
irregulars
so for example forecasted
and something that sells really used to divide
price cell division
so if you get the body politic acid
cancer cells and useful classics defied a lot more
read more readily men
doctors say this is a doctor who really did
impeding well-meaning
you live and die
keeping the bodies start with a
anyway targeted we didn't need a vastly nothing and i was on the advice of our
heart doctor
leading in the morning
in any kind of vitamin
and this is they have some doctors disagree with this
we chose to
follow that it now
pursuing recently
as strong as possible
we did a lot of alternative methods
frank sinatra
well you know when you're first asap it anyways
really one of these challenges not only at it can be tricky
every second
so for example medicines like
tension hasn't called life
can survive
mandy unique and andy inskeep
rivets anything it's clean
properly even if you have cantaloupe
exchange of washing properly
it's like i said i never used that night
if you cancel it
inside the cancelled
so to speak it was a real challenge
mostly beating him whenever i meet you create a lot of
sunset nutritious
would just get little sightseeing tour
indeed it will be well
and in retrospect you know
i was shaken a better job of that
so he went from being
he started to treat abuse of the dayton fifteen counts within
monthly spent seventy
i don't know that i would have any
defenders are unique and i was constantly pretty healthy
we have a check
but we know that uh...
treatment changes at this moment
inuyasha
i think it looks
we know that agreement that you have many natin
organized ***
one thing that's very important that the international
updating tell me this
portland you know you getting to know if you're getting keen on a wednesday don't
wait till wednesday to get the attack
and societies
forty hours
stand out that in their system
eighty canon ixus
it's better to have a delta uses to inspire
use incentives so frank
treatment cave
instilling options
i think i would say ten most stupid
indices chronic heart hazards
i wish i had
he had also
that maybe it just seems to be asked
which causes the property
and down because of the
foot drop in the property
because this is not listening
and yet you know that
the messages dental care as per person
so while he was churches and visit
yet i just keep it isn't
for most of the first
six months to a year
and he was on the water
and he acted
you don't know how quickly you can imagine
and they can't tell you sitting laps
and missus will be teaching as isn't it
mobility body is meant to be a right
wants in on into the line ten
given when you when you're lying down
any muscle sachet he can imagine
adapting
they're not mobile acting because the chemo
anti-jewish i insisted on him
overspending
two months later
spirituality
problems with the story
protection of the muscular system
so just to
make sure it was done
while your bungalows
no i don't go on
had no strength
no appetite
ubi
he should have
getting hot
roman more active
more so that he was yes
at that
then again is very challenging
i'm not talking about going out for a job
occasional lap
around the hospital and while we were in and we are home
i wish they had
it was hard to say it took four because even when he was going to keep eating
experience
but i wish i had just how walking
what was referred by ms
affected siblings
just due to surgery
since i won't
action say i'm wondering too close together
here for two years we really can't leave the house
daughter in particular since very close to my
point she became second mother
crashes in ninth grade at the time
anxious to scraggly and last night
de monday night she subsequently also display all of this
her grades up
likenesses
she socialite
integration st
that's every friday and saturday night
kids around more often than not sheets home with us
it really could be around people so we were going to lead
d_n_a_ wasn't
she stepped
occurred about ten twenty am on arriving just right around him
but at the same time you know she was an angry and most of the first few months i
wasn't
she did not have a lot of parental supervision
i live in detail
i can tell you the outpouring of love and
support that we've seen
they created a website with breast and have recently
and they wanted to continue after coming here
initially i did not accept and just not something that likes to take help
may not make it
because when i was
in the hospital with me and peace of mind
next election
i thought it was a nice
treatment centers and ten
n_b_c_ had a nice work
anymore just
dedicated
beautifully draft
desserts
and and i had such peace of mind
every night
but it's hard being there were nine ten painted alive rentals
faring beyond
and i want to get started
do their kids
i mean my kids are doing okay now
i mean my oldest son
but i've been families right now
and youngpeter
bnvsrinivas kids were any training walk back
income home everywhere
to me i i had my heart broke free
really needed here is a
there's only so much
well they don't want to argue that the inability
it seems like a little thing
you need your body to be strong
there's only so much
due to keep his job
obits along the way there
i don't think i would have also
i never people
were at my seats down who said that
going back to normal
and the entire nine everyday in every case back to normal one-year-old part
i think i would like to have no impact
that was true
nineties and i think
spectacular living here you have to do
declined to yourself
very very much
i had to forgive myself a lot because
obviously have
much guilt
forgive myself
with its
well at the beginning when he was antagonist
i wish i
viewpoints
hold on form w
with the kids
hong
your story
mixed case
cases extreme
there there are kids who
i'd look at them and i hike
nearly resisted
but their kids that i'm amazed at one point you can
was when you're older than me
needing any of the vast
grosses
is stage one
and i don't really think that's a lot to do at that stage
won a stage
i don't really think when you're dealing with you're dealing with i think it's a
siege
his first treatment goes what state you're in
because the treatment is the same
almost here and want to ask for
it's the same
except for the premium reduction feel mediate the radiation didn't really
beaches treatment actually
and the only really statewide worried about long-term because the cream
mediations
tension tara
yank recreation because they found when they did a spinal tap
we haven't sena realist i know
ask sir i was checking
during treatment was every month
got rid of treatment
still get
we have been done in three months it now
for six months
so because they found a couple celsius finals
mission there was a lot of
there was some doctors who do you do you think you need a ticket was there's a
lot of discussion
and we opted to go for it because
the risks dearest
debate isn't as far away
and i'm done
doing act
tokyo's forty seconds
was a two-week period five days forty seconds and identify
instant and isn't
the biggest he was more tired during that
they say it was presented
it was just in case maybe there was this salad they can
to bring a smile
apparently bijou
really kills does a good job
is the key but doesn't that you could likely be airing
securities across
spine system
city
within the c_d_c_ treat
the spinal column with chemo
directly
as the of the bride blood-brain barriers
doesn't posso
and actually twenty five years ago a lot of kids
when they were first reading
zicam relapse because they didn't have to decide
predominantly a lot of kids relapse in the spinal column
tells a lot of choice the last
so that's it
so the uh... the revision was to keep and will respond
just to bring
which date date
delta mask
iran's faced
texas face
and the just directed
to move
you have a little bit of concern about developmental
you know bernie
so far we
which i think that we had tested in the beginning to get a baseline
to see where he was at
going forward
a blood test in the city
cities and stuff
really out not to do that
push for longer
time for him more time
rapists
seis de tocqueville gives him great
but i don't notice any young
impatience is actually doing patterns
now than ever
matured a lot of mostly in it
ought to say
lynch's it after the interior
receiving a lot
jersey kallins
from florida no parents reporting from texas
all i absolutely excellent ceremony but you can't
being of families
but i'd also that families and identities charity
you know once you get the doctors we really have to put a lot of feet deep
into the same time you billy
an expert at these protocols back to really
i mean there were one or two occasions where for example
because
apparently
diseases in his findings
did you see rising is a part of a elisa chemo
but usually it is not in this case nineties penicillin instead
mixes in his spine east exit
jesse jackson is a nation
more susceptible
but there were couple times that it is going to get up at his own send expected
so
i'd remind you know
against accidents
so you really have to even though they're very very good they were
very rare occasions
note your child's disease
back together
and um...
stay on top
your your habit
the queen of the room
section of the webster
we're pushing
you gatekeeper
rotunda surrey news phoenix
long-distance
would be done properly
do you know i mean i have to remember
sets the entire
uh... then he had anything else is he l
so there's a certain area
accessing them
reports and some are not
most of them are very good
i don't let anybody touch mein
he's going to be too much nobody takes his place
i mean it's not even the party
since the crash mccartney obscenity anybody associate that hostel is so
wonderful
we have you know that night
we may end up in the uh... emergency room
and then started to really know
in their system
pediatric patients as well
and i says no i want to meet the pediatrics
access in my judgment against explains
i mean i think the idea of what i think it's wants you
you're done with treatment
i didn't really realize
live in a moment of the asi how did you get to this heavily anything too far
ahead because mike tyson chair and he was over
i really just
the week ahead of me any obviously
think about the future to some extent
what i needed to get through them
you know but now there are fourteen months at a treatment angrily
they say he did
andy year after treatment me
tell you all the
at risks given the treatment
mickey's potentially enormous nothing i scare parents but this is where in an
airport
more arrests
forum
for the first ten years
they say it's a very small risk
and then after ten years that
his response
you yours and mine is his as well but that is what i was reading text
but you know that you had a at the end of treatment
captain eastern c_n_n_ technologist follows fellowship
and they give you a summary of all the dresses added for example in spain
test oxidants
and uh...
koss described it
do you know i may not be picked up
cardiogram
slumming stop itself
actually one thing they'd ever told me during treatment which basic m_t_v_ did
i miss you so
distraught i didn't hear it
keith here on this particular driving us has ever lived within ten ten thirty
p_m_
because
you know you don't want blood pressure space
when physical therapy wasn't letting working
stadiums the entire two years
and now it really kind of
deciding whether or not we needed
i think that's not a lottery
can get your money back and she became
me i'm not saying that one
pumping iron
zapak gracefully
say it
you get dat when u get the summary of all the
tential dress
all these different times
much greater risks
and really have to be on top of that
when she's out as hearsay
every organ
rehearsing
conservative issues
elastic c_n_n_ industry in india where missionary work on stage in the party to
celebrate
nintendo
when it actually brought the railing
we were actually both really depressed
worry because she was
undergoing chemo yet
seeking and that you cannot make me laugh
we were terrified
cat scans every three months and everything
treatment is the ultimate literally
irrespective
yet a lot of them
emotional problem
had panic attacks
we expected to just be me and so happy ending
depressed and scared
it took about it
every every three months ago little better
in an f_ fourteen months and i think
the e_s_p_n_'s i didn't really worried that you always were
the war it wasn't ability
slip into depression
so i guess unemotional
level and that's it
stratus you really have to just
like i said to speed
educated me as much as you can
talk to your doctor
my experiences lotus feet
the e-ticket bear against information easier
here to read the spectrum
doing anything
and they just
it's too much annex one
just tell you each a and treatment
alaska's
insist children
to your parents who want everything
everything i wanted to know
how to sell divides at every level
think one thing i i think i can
tell you about seventy
it's a very calm but one thing i didn't know all other itself classes and then
is this out to be dormant
remaining here is where it is not dividing at all
estimates here eating because
kenya wondering cell
that's not dividing you can kill it
is only dividing celtic event
so you can have a cell that's thirty four nearly every answer the question
for me how long it could be doormen and never had that question answered i don't
even know unmitigated one scare me
because if it's five years and treatment into excel comes at a living
three years down the road and obviously
the more often than not
wanted a big
worries on treatment especially by
for example my sons played itself to a very low level so they had 'em
on the senate seat
they were really
king is is that
when your have very low doses the southbound resistant
so any development assistance
thank you know that a b
and found that i guess a lot of question
income taxes
before i realized why i was so worried about
took a lot of questions
void if there was a reason to be interviewed
yet it's scary
of aids and there's nothing to do about it
and a very good book i read actually uh... earlier and it's called the buyout
has called the environmental it is a biography of cancer won the pulitzer
team has any
i didn't really realize what i picked up the book that the
brandon's actually
and you know the all the same drugs at these for the peace now the east twenty
five years ago
it's just how they eight read all the side effects
can survive
and also um...
feedstock
but all the same dot said the houston twenty-five thirty years that means
almost fifty seven ever is fifty years ago
but it's how they interact
cavities side-effects sent
so that's another thing
roadside sometimes
let me speak to parents elsewhere other countries
missing
the treatment here may be better b
that'd be great but the
political news
and then i'm going
it's much more than a political
much more than a week
chemo deep blue sea
because this is market
each has its challenges of different
many many
smaller bigger decisions
needs to be taking
that's right
i guess if he's an artist and even many of them there's a system that works and
i'm just saying that the nurse practitioner
figure he spent the last time
so that they
you know i would worry about his doctor centers making the right decision they
mock
hasn't gotten too since millions of snow
this is the right thing
tweaking
i think you're right that so many other possible
me when you see
illuminations three indications at patni dot the same inspite
any other house donating to charity
we can't know that i mean we don't know what's going on and be understood
judy shop in boston
they may also have
rejects readjustment
no i think it probably seems u
disappointed
and chicago repaired and thank you
you would be treated even if you're interested for only any other eight
detail
the congressional relations
in thailand and crying
activities
we all love and kids
this is one of the things that helps you get
the team in average issue indicates that you see it slowly
we although we love our kids but it's almost just like
with other parents and kids and you feel it
of my son and i are just
interconnected
we can almost reach into his mind
very special
quality three kids he's always been the kindest
three times as he said to me that he never gets it
you know he's
speaks harshly to meet jackie collins apologize
very very special
sixty three
full of gratitude for how much you care
i see things in myself i didn't know where they're
who would think i can carry a hundred here point loss
no i do it
minorities i was up for forty eight hours
your skill to select one
anti-christian