Dear friends and family,

I have some updates for you about Gabriel.  As many of you know, he had recently received a series of scans and tests to determine where we stand with his tumors.  Prior to these tests, Gabriel had been developing a lump on the back of his head which had Brandy and I concerned.  The tests had revealed both good and bad news.

The good news is, that all of his previous tumors show that they have regressed.  Even though they were still present, this was/is encouraging to know that there were clear signs of gaining ground.  Unfortunately, and remaining consistent with every inch of this battle we fought thus far, with this good news comes bad news.

The bad news is that there are four new tumors, the back of his head being one of them. (1) Back of his head: ½ golf-ball size (2) On his brain: pea-size (3) Hip: pea-size (4) Hip: pea-size.

This last Monday (November 16), Brandy and I had a consultation with his Doctor and some nurses to review some treatment options.  A majority of these options are Phase I treatments, meaning, they are strictly experimental.  In order for us to enroll Gabriel in a Phase I treatment, we have to understand that Phase I treatments are designed for the improvement of medical science as opposed to strictly patient care.  Along with these Phase I options, we also have a conventional option available.  This option is a low dose Chemo, but it is for the objective of sustaining instead of curing.  Thus, Brandy and I has come to the conclusion that we will go with a Phase I option that offers an opportunity to directly attack the tumors and/or cancer, using the low dose Chemo as a back up option for the just in case.

Today, Brandy is at the downtown Riley for a scheduled surgery for Gabriel.  He will have the same port he had before placed back into his body for treatment administration.

On another note, I have been working to improve our ability to update everyone in real-time about Gabriel.  Also, I am trying to make it as interactive as possible.  So, here are a couple of new things to look at;

Become an Angel of Gabriel and follow him on Facebook

http://www.facebook.com/pages/Bedford-IN/Angels-of-Gabriel-Michael-Howell/178717514940

I encourage you to also view his new Website;

http://gabrielmichaelhowell.weebly.com/

As always, thank you all for your love and support,

-The Howell Family

James, Brandy, Gabriel, and Ezekiel

----- Original Message -----

From: Angel Eyes

To: GabrielMichaelHowell@yahoogroups.com

Sent: Wednesday, November 04, 2009 9:38 PM

Subject: [GabrielMichaelHowell] Quick update

As many have been wanting to know how Gabe is doing and what is going on, I am finally getting on here to do a brief update.  Many of you already know that we have been concerned about a bump on the back of Gabe's head and we have been watching it very carefully.  This is week 4 for this bump and it is not going away.  At first we thought maybe he had just hit his head, or that maybe Zeke has hit him...that is still a possiblity, but we have to be cautious and so he went to the doctor yesterday and the doctor has looked at it, however, did not have any answers w/o having a test done.  Therefore, a PET/CT scan  has been scheduled for Tuesday, November 10th at Methodist Hospital in Indy.  They are going to do a full body scan to check the bump on his head as well as see what exactly is going on in the rest of his body.  His last PET/CT scan was done in January of this year, so it has been awhile.  This test should tell us if the areas that were active in January are stable or still growing or even better, gone completely. 

Gabriel has been acting like a normal 3 year old and has really enjoyed being home.  We have been able to stay home since late September and it has been great!!  He did have some blood work drawn yesterday while at the clinic and for the first time ever...there were NO red flags on any of his counts...everything was perfect from what I was told.  This is very exciting especially since he has not had any treatments since August. 

Thank you to all of you for being patient w/ us as we have not been posting much on here...and this time...no news has been good news.  We appreciate all of you for your continued thoughts and prayers for Gabe's healing.  GOD has indeed been answering prayers and continues to heal Gabe's body everyday.  He looks great and has tons of energy.

Sincerely,

Brandy Howell

As many have been wanting to know how Gabe is doing and what is going on, I am finally getting on here to do a brief update.  Many of you already know that we have been concerned about a bump on the back of Gabe's head and we have been watching it very carefully.  This is week 4 for this bump and it is not going away.  At first we thought maybe he had just hit his head, or that maybe Zeke has hit him...that is still a possiblity, but we have to be cautious and so he went to the doctor yesterday and the doctor has looked at it, however, did not have any answers w/o having a test done.  Therefore, a PET/CT scan  has been scheduled for Tuesday, November 10th at Methodist Hospital in Indy.  They are going to do a full body scan to check the bump on his head as well as see what exactly is going on in the rest of his body.  His last PET/CT scan was done in January of this year, so it has been awhile.  This test should tell us if the areas that were active in January are stable or still growing or even better, gone completely. 

Gabriel has been acting like a normal 3 year old and has really enjoyed being home.  We have been able to stay home since late September and it has been great!!  He did have some blood work drawn yesterday while at the clinic and for the first time ever...there were NO red flags on any of his counts...everything was perfect from what I was told.  This is very exciting especially since he has not had any treatments since August. 

Thank you to all of you for being patient w/ us as we have not been posting much on here...and this time...no news has been good news.  We appreciate all of you for your continued thoughts and prayers for Gabe's healing.  GOD has indeed been answering prayers and continues to heal Gabe's body everyday.  He looks great and has tons of energy.

Sincerely,

Brandy Howell

----- Original Message -----

From: KingCasper211

To: GabrielMichaelHowell@yahoogroups.com

Sent: Monday, October 12, 2009 8:28 AM

Subject: [GabrielMichaelHowell] Update 10/12/09

First, I would like to apologize for the lack of updates over the last few months.  Besides having a full calendar, things change quite regularly…but, no excuses.

Gabriel has been doing excellent for the past few weeks, even though he had given us a little scare with a mild fever which only lasted a short period of time.  The last CT scan he had received confirmed our hopes that his tumors have indeed been shrinking beyond any shadow of a doubt.  Furthermore, the tumors on his jaw appear to be scare tissue, as opposed to tumors.  We have officially taken him completely off of CHEMO treatment, and he doesn't have any foreign objects in his body used to administer medications.  This is hard to get use to for us (Brandy and I), but he acts and plays as if it has been out his whole life.  This has allowed Gabriel and Ezekiel the opportunity to interact more like brothers, which is absolutely hysterical!  They can get pretty wild at times.

Gabriel has had a few bloody noses since we have been in this new stage.  However, each bloody nose has been followed by him hitting it in some way, shape, and/or form.  Albeit, it does make Brandy and I pay closer attention to that area, just in case…as it does seem to bleed with little effort.  In a few weeks, Brandy and I are planning full body scans…which include, but not limited to, MRIs.

I will work harder to get out more updates, instead of allowing so much time to elapse between them.  Hopefully, one of my next updates will bring news of remission.

Loving you all,

The Howells

James, Brandy, Gabriel, and Ezekiel

First, I would like to apologize for the lack of updates over the last few months.  Besides having a full calendar, things change quite regularly…but, no excuses.

Gabriel has been doing excellent for the past few weeks, even though he had given us a little scare with a mild fever which only lasted a short period of time.  The last CT scan he had received confirmed our hopes that his tumors have indeed been shrinking beyond any shadow of a doubt.  Furthermore, the tumors on his jaw appear to be scare tissue, as opposed to tumors.  We have officially taken him completely off of CHEMO treatment, and he doesn't have any foreign objects in his body used to administer medications.  This is hard to get use to for us (Brandy and I), but he acts and plays as if it has been out his whole life.  This has allowed Gabriel and Ezekiel the opportunity to interact more like brothers, which is absolutely hysterical!  They can get pretty wild at times.

Gabriel has had a few bloody noses since we have been in this new stage.  However, each bloody nose has been followed by him hitting it in some way, shape, and/or form.  Albeit, it does make Brandy and I pay closer attention to that area, just in case…as it does seem to bleed with little effort.  In a few weeks, Brandy and I are planning full body scans…which include, but not limited to, MRIs.

I will work harder to get out more updates, instead of allowing so much time to elapse between them.  Hopefully, one of my next updates will bring news of remission.

Loving you all,

The Howells

James, Brandy, Gabriel, and Ezekiel

----- Original Message -----

From: James B. Howell

To: GabrielMichaelHowell@yahoogroups.com

Sent: Wednesday, August 19, 2009 9:23 AM

Subject: [GabrielMichaelHowell] Update- 08/19/09

Greetings friends and family!

I know it has been four weeks since the last update on this group-site!  For this, we apologize…it has just been real busy for us as of late.  Anyways, here is a little update about Gabriel's current condition.

Bitter-sweet, is the best way to explain it…why?...As most of you know, Gabriel had a CT scan done this last Monday (August 17^th) and the results are indeed positive!  It is official that the tumors are shrinking…Gabriel has won this battle!  So, where is the bitterness in this you may ask?  Well, the treatment that has proven successful in this fight, has become Gabriel's Achilles Heel.  I.e. his body cannot take too much more of this treatment, otherwise it will not be the tumors or cancer that causes his death…it will be the treatment.  Life sure isn't easy!  The medical staff caring for Gabriel say that he will/should be able to handle two more treatments without any immediate threats, like his liver/kidneys shutting down.

Thus, our game-plan!  We had thoroughly considered/weighed our options, and have come to the conclusion that we will exhaust the Ice Treatment by using the two more treatments.  Gabriel will have another CT scan during/around his final treatment.  We will then take him completely off of any and all Chemo for at least six weeks, which at this time he will undergo another CT scan and possibly, MRI.

At this point we can not solidify a guaranteed direction, thus we are coming up with as many options as possible.  From today, until the conclusion of the six-week (drug-free) period gives us three, to three and a half months to research any possible options that are currently unknown to us. 

Best case scenario, the CT scan at the end of the six-week period proves the tumors are still regressing, then we will reestablish another drug-free period of time…concluding with another set of scans/tests...repeating this cycle until we have won the war, or, we have to utilize a back-up plan.

Worst case scenario, CT scan at the end of the six-week period proves the tumors have adapted and overcome, re-rearing it's ugly head.  We have an oral chemo (I'll leave the details to Brandy) treatment currently in our arsenal to fall back on.  However, and our hope is that, by the conclusion of the six-week period we'll have uncovered, at least, another treatment option.  If during the six-week period the tumor take a turn for the worst, then we will implement this option immediately.

Apparently, it had been mentioned to Brandy, that the medical field has an option of (I don't know what they officially call it) administering, not necessarily random, but various drugs "to see what it does."  Along with this "treatment" comes an understanding that this is not for the patient's benefit, instead, it is simply for the medical field in and of itself.  Personally, this IS NOT an option!  Gabriel will not EVER be reduced to solely a science experiment, even though I know to a degree he currently is.  I may be wrong in thinking like this, but, if a treatment is not administered with the specific goal of healing Gabriel with a realistic chance…then it will not be administered.  I will not watch my son endure possible torture that may come from something like this.

Anyways, I apologize if my update was not as detailed as you are accustomed to.  I am not much for medical jargon!  As always, I (we) deeply appreciate your continual support/prayers as we walk through the valley of darkness and shadow of death.

With love,

-The Howells

James, Brandy, Gabriel, and Ezekiel

Greetings friends and family!

I know it has been four weeks since the last update on this group-site!  For this, we apologize…it has just been real busy for us as of late.  Anyways, here is a little update about Gabriel's current condition.

Bitter-sweet, is the best way to explain it…why?...As most of you know, Gabriel had a CT scan done this last Monday (August 17^th) and the results are indeed positive!  It is official that the tumors are shrinking…Gabriel has won this battle!  So, where is the bitterness in this you may ask?  Well, the treatment that has proven successful in this fight, has become Gabriel's Achilles Heel.  I.e. his body cannot take too much more of this treatment, otherwise it will not be the tumors or cancer that causes his death…it will be the treatment.  Life sure isn't easy!  The medical staff caring for Gabriel say that he will/should be able to handle two more treatments without any immediate threats, like his liver/kidneys shutting down.

Thus, our game-plan!  We had thoroughly considered/weighed our options, and have come to the conclusion that we will exhaust the Ice Treatment by using the two more treatments.  Gabriel will have another CT scan during/around his final treatment.  We will then take him completely off of any and all Chemo for at least six weeks, which at this time he will undergo another CT scan and possibly, MRI.

At this point we can not solidify a guaranteed direction, thus we are coming up with as many options as possible.  From today, until the conclusion of the six-week (drug-free) period gives us three, to three and a half months to research any possible options that are currently unknown to us. 

Best case scenario, the CT scan at the end of the six-week period proves the tumors are still regressing, then we will reestablish another drug-free period of time…concluding with another set of scans/tests...repeating this cycle until we have won the war, or, we have to utilize a back-up plan.

Worst case scenario, CT scan at the end of the six-week period proves the tumors have adapted and overcome, re-rearing it's ugly head.  We have an oral chemo (I'll leave the details to Brandy) treatment currently in our arsenal to fall back on.  However, and our hope is that, by the conclusion of the six-week period we'll have uncovered, at least, another treatment option.  If during the six-week period the tumor take a turn for the worst, then we will implement this option immediately.

Apparently, it had been mentioned to Brandy, that the medical field has an option of (I don't know what they officially call it) administering, not necessarily random, but various drugs "to see what it does."  Along with this "treatment" comes an understanding that this is not for the patient's benefit, instead, it is simply for the medical field in and of itself.  Personally, this IS NOT an option!  Gabriel will not EVER be reduced to solely a science experiment, even though I know to a degree he currently is.  I may be wrong in thinking like this, but, if a treatment is not administered with the specific goal of healing Gabriel with a realistic chance…then it will not be administered.  I will not watch my son endure possible torture that may come from something like this.

Anyways, I apologize if my update was not as detailed as you are accustomed to.  I am not much for medical jargon!  As always, I (we) deeply appreciate your continual support/prayers as we walk through the valley of darkness and shadow of death.

With love,

-The Howells

James, Brandy, Gabriel, and Ezekiel

Since the last posting Gabe has not had too much going on.  He did finally get over the  c.diff infection and has finished his meds for that.  He went thru a week of chemo last week and was so full of energy the entire week that it was rather difficult to keep up w/ him.  His brother Zeke was here too for a few days along w/ a good friend (Charity) of ours that helps out w/ watching Zeke a lot of the time.  She is very helpful and we thank her so much for her continued support.  Zeke was rather busy the entire time he was up here too since it has been several months since he had been here, he had to of course run around and check everything out again.  :)  It was good to have him here though and Gabe really enjoyed being able to play w/ him more. 

When chemo was over last friday (7-17) we went to Palestine to spend the weekend and pick up Zeke from the family and Gabe got to play outside and have lots of fun!  He pooped out Sunday afternoon/evening though and slept all the way home to Bedford. 

His blood counts yesterday were fair...as to be expected.  We decided to go ahead and have him come up to the clinic today (Tuesday) to see what his counts were today and get the needed transfusion(s) and go ahead and admit him since we have learned from the previous rounds of treatment what to expect (to a degree at least).  Good thing we did too because as we initially thought, his counts crashed overnight.  His WBC went from 2.7 to 0.2 and his Hgb went from 8.3 to 7.2 and his platelets went from 80,000 to 41,000.  His ANC went from 2484 to 90 meaning his is neutropenic again and cannot leave his room until his ANC recovers to 500 or above.  This will take days to happen as he is still dropping in counts.  His received a Packed Red Blood Cell (PRBC) transfusion this afternoon to get his Hgb up and will most likely receive a platelet transfusion tomorrow at some point in time.  He will then receive more blood and platelets later in the week/weekend.  As of now, he has still not spiked a fever, which is not normal.  He always spikes by early afternoon on Tuesday following his chemo, but today he has proved otherwise.  I'm figuring he will spike in the middle of the night as his counts drop more. He usually has 3 PRBC transfusions and 2 platelet transfusions after his chemo. 

He does have some thrush starting on his tongue and some redness in his mouth and he is not eating well (actually hardly at all) but he is still drinking fluids.  He has been started on the fluconazole for the thrush.  He also has the option of getting morphine if he is in pain.  We did  have to give him some morphine this afternoon for having some stomach pains that he was complaining about for awhile.  Hopefully we will not have to put him on any pumps this time for continuous pain meds like we did after his 1st round of this chemo.  The 2nd round of chemo went smoothly except for the c.diff infection. He didn't need any pain meds after that round. 

His doctor, Dr. Sharon Smith, will be leaving Thursday to take another job in Michigan.  I would like to wish her the best as she moves on w/ her career and that she will be missed.  The downtown Riley docs will be filling in a couple/few days a week up here.  From what I gather, it is still a mess as to what exactly is going to happen w/ scheduling and clinic visits and all.  I'm sure it will work out eventually and it is going to be a rough couple months before the new doctor that has been hired to replace Dr. Hock can begin in November, but we will manage somehow.  I have voiced my opinion about having to move downtown for treatments and sick admits and let them know that we will not transfer back down there.  We will stay were we are at or go elsewhere. We are very comfortable here at Clarian North/Riley North and everyone treats Gabe very well and he knows them very well.  He likes it here a lot, which we couldn't say the same about downtown.  The doctor we had downtown, Dr. Shih will be the doctor that Gabe has been assigned to if there are any questions or concerns regarding his treatment.  He will be the one who suggests procedures/treatment recommendations etc if the need arises until the new doctor begins.  Please pray that the next few months go smoothly w/ no problems or hiccups. 

Gabe is doing very well and looking great considering all he has to endure.  We spend almost 3 weeks of every month in the hospital and home for a week.  This is very trying on everyone, but it is for the best for Gabe.  Please pray that his next scans show positive results from this chemo and that we can try to move to another step (if there is one at this time). 

I would like to congratulate my friend Jackie (who I went to high school with) and her daughter, Sydney.  Sydney has been battling cancer and has kicked cancer in the butt!!!!  She is cancer free now!!! 

Thanks again to everyone for your support and prayers, we ar so grateful to you all!
Brandy

----- Original Message -----

From: Brandy Howell

To: GabrielMichaelHowell@yahoogroups.com

Sent: Tuesday, June 30, 2009 2:01 PM

Subject: [GabrielMichaelHowell] as of 6/30/09....

Unfortunately, due to a new infection, we will remain in the hospital longer than hoped for.  You cannot imagine our frustration with this, but at the same time, we understand that accidents like this do happen. 

 On Monday, his stool sample that was sent to the lab tested positive for c.diff.  We believe this is the cause for his fevers to continue.  He has been started on a new antibiotic, called Flagyl, to treat for this infection.  He started it more than 24 hours ago and we are hoping that the fevers will stop soon.  His temp has not reached the high levels that they had been since we have started this new antibiotic, so that is encouraging.  We were hoping to go all day today w/o any fevers so that we could possibly go home tomorrow, however, that didn't happen as he spike a fever again about 12:30 this afternoon.  He is still on Cephipime and Fluconazole as well, which was to possibly prevent any other types of infections while his counts were low and his immune systems was down. 

It is believed that the infection was contracted via another patient, (even though Gabe has never left his room since admission), who has since been discharged and no one realized this patient had it until after leaving.  Therefore, the entire unit is being disinfected w/ bleach today and the carpets being cleaned as well in order to prevent any further spreading of this infection.  Anyone coming into Gabe's room must clean their hands w/ the alcohol foam, put on gloves and a gown and before leaving the room,they must remove their gown and throw the gloves away and wash their hands w/ soap and water.  Kind of a pain, but much needed measures to prevent it from spreading to someone else, which is very important. 

His blood counts are good today and have jumped up rather quickly, which is great!  He has slept almost all day everyday since we've been here, which is good for him if he isn't feeling well, but hard to deal w/ on a daily basis sometimes.  Luckily he has not gotten the mouth sores like he did before and has not been on pain medications this time either.  These are 2 very good things in our opinions considering how much he has been through. 

Hope everyone enjoys their 4th of July weekend and please stay safe!  Thank you everyone for your thoughts and prayers. 

Sincerely,
Brandy

Unfortunately, due to a new infection, we will remain in the hospital longer than hoped for.  You cannot imagine our frustration with this, but at the same time, we understand that accidents like this do happen. 

 On Monday, his stool sample that was sent to the lab tested positive for c.diff.  We believe this is the cause for his fevers to continue.  He has been started on a new antibiotic, called Flagyl, to treat for this infection.  He started it more than 24 hours ago and we are hoping that the fevers will stop soon.  His temp has not reached the high levels that they had been since we have started this new antibiotic, so that is encouraging.  We were hoping to go all day today w/o any fevers so that we could possibly go home tomorrow, however, that didn't happen as he spike a fever again about 12:30 this afternoon.  He is still on Cephipime and Fluconazole as well, which was to possibly prevent any other types of infections while his counts were low and his immune systems was down. 

It is believed that the infection was contracted via another patient, (even though Gabe has never left his room since admission), who has since been discharged and no one realized this patient had it until after leaving.  Therefore, the entire unit is being disinfected w/ bleach today and the carpets being cleaned as well in order to prevent any further spreading of this infection.  Anyone coming into Gabe's room must clean their hands w/ the alcohol foam, put on gloves and a gown and before leaving the room,they must remove their gown and throw the gloves away and wash their hands w/ soap and water.  Kind of a pain, but much needed measures to prevent it from spreading to someone else, which is very important. 

His blood counts are good today and have jumped up rather quickly, which is great!  He has slept almost all day everyday since we've been here, which is good for him if he isn't feeling well, but hard to deal w/ on a daily basis sometimes.  Luckily he has not gotten the mouth sores like he did before and has not been on pain medications this time either.  These are 2 very good things in our opinions considering how much he has been through. 

Hope everyone enjoys their 4th of July weekend and please stay safe!  Thank you everyone for your thoughts and prayers. 

Sincerely,
Brandy