Saturday April 6, 2013

Toet, Leonard Martin

Our heavenly Father, in His infinite wisdom, called Marty home on April 6, 2013 after a courageous battle with cancer.  Marty was the beloved husband of Erica (nee Veenendaal) and father of Johnathan, Thomas, Sean, Davin and Kailynn.  He was a loving son of John and Audrey Toet and dear brother of Amanda and Mike Nederveen, Jolene and Ivan Byl, Russell and Jossi Toet, Ashley and Matthew Tiggelaar.  A loving son-in-law of Peter and Trudy Veenendaal, Marty was also a dear brother-in-law of Melanie and Theo Beijes, Chris and Kristen Veenendaal, Alison Veenendaal and Darryl Shpak, Trevor and Kelly Veenendaal, Owen Veenendaal and Arlene Vanderdeen, and Regan Veenendaal.  He was the cherished oldest grandson of Leonard and Janni Toet and Sy and Jenny Raap.  He will be missed by 5 nieces, 7 nephews, many aunts, uncles, cousins, friends, colleagues and students. Marty will also be missed by past and present students of Maranatha/Emmanuel Christian Schools where he spent his entire 15 year teaching career.The family wishes to extend their sincere gratitude to the Canadian Reformed Church and School communities, neighbours and Juravinski Hospital staff for the love, care and compassion shown to him and to us all, especially during the last nine months. Friends may pay respects and meet the family at The Emmanuel Canadian Reformed Church, 8037 Highway 7, Guelph (on Tuesday, April 9;  2 – 4 and 7 – 9 p.m).  Funeral service will be held at the church on Wednesday, April 10, 2013 at 11 a.m. Arrangements entrusted to GILCHRIST CHAPEL – McIntyre & Wilkie Funeral Home (519-824-0031).    In lieu of flowers, memorial contributions to the Emmanuel Christian School Athletics Department would be appreciated.  We invite you to leave your memories and donations online at:  www.gilchristchapel.com

"I will praise You as long as I live, and in Your Name I will lift up my hands." Psalm 63:4 NIV

Post Chemo

Humanly speaking it seems as if Marty has made it through the most difficult part of his chemotherapy.  I know we posted that the chemotherapy was completed already but after the actual treatment there is a period of time where the chemotherapy goes to work and destroys his whole immune system.  Over the past week Marty has had continuous fevers, dealt with thrush and mucositis in his mouth, been diagnosed with c. difficile, pneumonia, a bowel obstruction in the small intestine.  The thrush and mucositis are almost gone. He has been fever free for approximately 24 hours now and it seems as if his White Blood Cells are recovering.  We wait for platelets and hemoglobin to recover and in the mean time he receives transfusions for these as needed. Marty lost his appetite (effect of chemo) early in the week and since Thursday he has not been allowed to have anything by mouth due to the bowel obstruction.  He has an NG tube through his nose to his stomach to drain any of the bile that has been accumulating there.  We are very happy to note that the drain has actually not been draining very much bile in the last 24 - 48 hours, which is a good sign. Hopefully they can remove the tube soon.  After a few days of no bowel movements, things have started to move again and much of Marty's abdominal discomfort and distention has subsided.   Due to the pneumonia Marty's oxygen saturation levels have dropped and so he has been placed on an oxygen mask.  At this time Marty is receiving TPN, a form of nutrition through an IV.  He is however, looking forward to eating again.

So now we are waiting to hear when the next MRI will be and we will find out what this most recent round of chemotherapy has done to Marty's brain tumour. 

We thank our Heavenly Father for the excellent team of doctors, nurses and other support staff for the care that they provide for Marty. Thank you for your continued thoughts, prayers and words of encouragement!

"I wait for the Lord, my soul waits, 

and in his word I put my hope.  

My soul waits for the Lord more than watchmen wait for the morning, more than watchmen wait for the morning. "

Psalm 130: 5, 6

"Praise be to the Lord, to God our Saviour, 

who daily bears our burdens"

Psalm 68:19

Stem Cell Transplant Procedure is Completed

Today Marty completed his stem cell transplant procedure. We are thankful to the LORD that this procedure could be completed, and quite successfully too!

Last Wednesday Marty began a very strong chemo treatment lasting for six days. Two chemo drugs were used -- one on Wednesday - Friday and the second on Saturday - Monday. These chemo treatments went well and on Tuesday, Marty had a "day of rest" from his treatment.   Between yesterday and today Marty had his stem cells, which had been harvested from him several weeks ago, re-injected (transplanted) into his body. The doctors were quite happy with how this transplant went as this can be quite the ordeal for certain patients. Marty himself dealt with all the commotion, discomfort and anything else he was enduring quite well. 

While the harvested stem cells were out of Marty's body, they were frozen. Yesterday five, 60 cc syringes, totalling 300 cc's of stem cells were transplanted back into Marty over about 35 minutes. Present at Marty's bedside in his regular room were: Marty, Erica, Dad Toet, three medical staff who's job it was to thaw the stem cells and load the syringes, one person confirming that the stem cells were actually Marty's, one person who was in charge of the whole procedure, a doctor whose specialty is stem cell transplants, and two nurses to constantly monitor Marty's blood pressure, pulse, and oxygen levels for the duration of the transplant. Marty was on oxygen during the procedure. To say the least, the room was full! Today, it was the same procedure: part two.

Marty received two units of blood which is quite normal for chemotherapy patients to receive. He was very quiet today and over recent days has been confused at times. This could be the result of the chemo treatments. 

Over the past few weeks, Marty's mobility and balance had been slowly regressing. Since starting chemotherapy last Wednesday his mobility and balance has improved somewhat. Naturally this has given Marty more confidence in his ability to get around. Last night he decided to try to make his way to the washroom (a room right in his room) and fell to the floor. At the time there was no one in the room. He was soon discovered and returned to his bed. Thankfully he only suffered a small scratch from his glasses and a small bump on the side of his head!

So now we wait. Ideally the chemotherapy will have dealt a significant blow to Marty's brain cancer -- time will tell. A doctor vaguely noted that perhaps an MRI will be done in a few weeks to see where the cancer's at. We know that these chemo drugs attack not only cancer cells but also red and white blood cells and platelets. So Marty's immune system was attacked by the chemo drugs and rendered virtually non-existent. Hence the stem cell transplant. God, in his wisdom, created stem cells which can become red and white blood cells and platelets as needed. The hope is that the transplanted stem cells, which were spared the chemo treatment, will go back to Marty's bone marrow and then start doing their job: becoming the cells necessary for a "new" immune system. Quite amazing!

"My frame is not hidden from you when I was made in the secret place. When I was woven together in the depths of the earth, your eyes saw my unformed body. All the days ordained for me were written in your book before one of them came to be."

-- Psalm 139:15,16 --

Wednesday, Feb 13

Last week we received the disappointing news that Marty's cancer has progressed.  The doctor ordered a MRI of the brain and a CT scan of the body to determine the cause of fevers that Marty had been experiencing. The MRI showed progression of the disease since the last MRI, which was done early January.  The CT scan however came back clean. The doctor immediately put Marty on high dose steroids to minimize his symptoms.  Marty and Erica have decided to continue on with the chemotherapy and the stem cell transplant which was the planned course of treatment.  While this is disappointing news we are comforted by the fact that our heavenly Father continues to uphold and sustain us through all things.  

Today Marty started chemo again.  Due to the fact that this is a very potent form of chemotherapy and that it is secreted through the pores of the skin, Marty will need to have a shower twice a day.  His room will also be given a thorough cleaning twice a day.  The chemo is given through IV and takes approximately 3 hours to complete.  He had his first dose at noon today.  They hope to get the chemo drug from the pharmacy a little earlier tomorrow so that they might be starting it by ten tomorrow morning.   Today, tomorrow and Friday he'll be given Thiotepa (a chemotherapy drug) and for the following three days he'll be given Busulfan (another chemotherapy drug). The risk of this chemotherapy treatment is that it is very potent and will kill good and bad brain cells and also wipe out Marty's immune system causing him to be susceptible to any infection. Without the stem cell transplant he would not be able to grow any new white blood cells, red blood cells or platelets himself.  Some other side effects possibly are mouth sores, nausea, vomitting and diarrhea.  

Following the six days of chemotherapy he'll have his stem cells transplanted back into his body.  Because of the preservative in the  harvested stem cells the transplant will take place over two days; next week Tuesday and Wednesday.  

Marty had a hearty appetite again today which is good to witness. We continue to hold fast to the promises given us by our heavenly Father that not a hair can fall from our head without his will and he will work all things for our benefit.  

 "Cast all your anxiety on him because he cares for you" 

1 Peter 5:7

" But the eyes of the Lord are on those who fear him, 

on those whose hope is in his unfailing love,....

May your unfailing love rest upon us, O Lord, 

even as we put our hope in you. "  

Psalm 33: 18, 22

Harvest Day 2

Just a brief note to let everyone know that Marty's second day of stem cell harvest went even better than the first.  The count was 2.25 million stem cells per kilogram for a total of 3.83 million stem cells per kilogram.  The doctor is very happy with these numbers.  

Marty did end up going home for the weekend.  We are not sure what the coming week will bring but our heavenly Father knows all and carries us all in the palm of his hand.

Harvest Day

Just a short update to let everyone know that the harvest went well today.  The count was 1.58 million stem cells per kilogram collected today and the doctor is happy with that.  However the doctor has decided to do one more day of harvest just to get as many stem cells as possible.  Tomorrow they will do one more harvest.  

The Lord willing Marty will be able to go home this weekend.  He has been fever free this week and for that we are very thankful.  We are not sure exactly when the chemotherapy will happen but we will keep you posted.  

Thanks again for all your support, words of encouragement and most importantly your prayers.

Psalm 31:24

Be strong and take heart, all you who hope in the Lord.

Preparation for Stem Cell Transplant

Here is just a short little update on what has been happening for Marty in preparation for the Autologous Peripheral Stem Cell Transplant.  Last week Monday Marty had a pheresis catheter inserted into his clavicle (shoulder/neck) area.  This was just a short procedure but has caused Marty some neck pain which is to be expected.  This catheter will be used to give drugs and fluid to him during the stem cell transplant.  
This past Friday, Marty did go home with the expectation that he'd be at home for the weekend.  However on Saturday, he was having problems with his balance and then started running a fever, so Erica did end up taking him back to the hospital early Saturday afternoon.  The doctors have given Marty antibiotics and by Sunday evening he was starting to look a lot better already.  
Sunday Marty received his first neupogen (growth factor) injection to increase the production of stem cells so there are enough stem cells to be collected on harvest day.   As it stands right now we are gearing up for Thursday, January 31st to be Harvest Day.  Marty will have to go to Oncology Day Ward from 7am until 7pm while his blood will be cycled through a pheresis machine.  By way of this machine his stem cells will be collected and then the remaining cells will be returned to his bloodstream.  By Thursday evening we should know if they were able to collect enough stem cells.  Optimum amount of stem cells is 2 million per kilogram of body weight.  
We will continue to keep you updated on what will be happening with Marty's care.  Thank you again for your continuous support and prayers.  

January 2013

Marty has completed his 6th and final round of chemo, and a follow up MRI has been done.  The MRI report for the most part remains unchanged after the completion of the 5th and 6th round of chemo.  The MRI does not show disease progression, which is a good thing; Dr. Fraser would describe Marty's response as a partial response to the 6 rounds of chemo he was given. 

On Thursday a support team briefed us on their 3 options as further treatment for the cancer which still remains in the brain.   Marty and Erica have decided to go ahead with the third option which is Autologous Stem Cell Transplant.  This is basically a procedure where blood cells are harvested, and then a round of  two different high dose chemotherapy is administered, with the hope that this will kill the remaining cancer cells and then the stem cells are transplanted back into Marty's body.   This stem cell transplant could take 3 to 6 months to recover from.  At the meeting we were again made aware of how rare a form of cancer Marty is battling with.  Doctors at the Juravinski Cancer Centre,  Princess Margaret (in Toronto) or in Canada, have not treated any other patient with Marty's cancer in this way.  The team is in contact with doctors in France and are currently basing their treatment plan on a research study based out of that country. This treatment plan is not without it's own risks and/or side effects. 

In the next couple of days Marty will have major blood work done, as well as other procedures in order to ready him for the harvest, ie. catheter insertion, injections of growth factors in order to increase his stem cells. The harvest is tentatively planned for the end of January and into the beginning of February, barring any  complications; we hope to keep you posted via the blog as we go along.   

We continue to covet your prayers at this time and pray that God will continue to sustain Marty and Erica and their family, knowing and being comforted by the fact that not a hair can fall from our heads without the Father's will, Lord's Day 1.    

 Jeremiah 29:11

"For I know the plans I have for you," declares the LORD, "plans to prosper you and not to harm you, plans to give you a hope and a future. "