<div>Hello and thank you for taking some time to visit our page!
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<div>Who is Evan?
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<div>               We would like to tell you about Evan Krueger, and his most recent journey.  Evan is an incredibly intelligent, and loving 7-year-old boy whom was originally from Nebraska (Go Big Red!!), and has been a resident of Iowa since moving to Roland, IA in December of 2016, then finally on a farm between Haverhill and Marshalltown since June of 2018. 
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<div>Evan attends Hoglan Elementary School in 2nd grade.  He has two older sisters.  Paige who is 9-years-old and also attends Hoglan Elementary, and Kaylee who is 12-years-old and attends Miller Middle School.  Evan is also a huge animal lover! He pours his heart out to both dogs and cats alike, and has a special love for Giraffes.
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<div>Evan has a smile and laugh that will warm any room!  He is extremely loving, kind, and considerate of everyone he meets and/or spends time with.  Evan loves to play with friends and with his sisters as much as possible.  Also he loves gaming!  Anything from Minecraft to Rocket League and countless RoBlox games in-between.  Along with playing games directly he enjoy watching several different streamers / content-creators on YouTube.  In-fact that is one of his goals / passions: to be able to begin live-streaming on YouTube or Twitch while playing games. 
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<div>When not playing games, watching games, or playing with his sisters, Evan enjoys children’s action movies and cartoons.  His favorites being The Avengers (mainly Spider-Man &amp; Thor), as well as Sponge Bob Square Pants. 
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<div>What changed?
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<div>               A couple weeks leading up-to November 7th Evan had been experiencing some different symptoms.  He was complaining of frequent headaches, followed-by nausea/vomiting but with no other symptoms.  No fever, or ear aches, etc… he would simply say his stomach hurt, he would get sick, and then a few minutes thereafter he would feel better and be fine / acting normal. 
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<div>On the morning of November 7th Dana received a phone call from the school indicating that Evan had gotten sick and needed to be picked-up.  Again, no fever, no indication as to what was causing his sickness.  The only thing out of the ordinary was Evan saying he fell down at school the week prior and hit his head.  There was no mark/indication, nor did anyone at the school know anything about this fall. 
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<div>Dana took Evan to Urgent Care in Marshalltown and he was referred to a pediatrician downtown at the hospital.  This is where he was first observed having difficulties walking in a straight line, and actually tripped over his own feet twice while in the office.  He was immediately taken to have a CT performed and that is when it was discovered that there was a mass/tumor between his brain stem and cerebellum.  The tumor was large enough to block the natural flow of the Cerebrospinal fluid (CSF).  This blockage was causing an increased Intracranial pressure (ICP).  The increased ICP was a life-threatening condition which was causing his nausea, vomiting, disorientation, headaches, etc…
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<div>Evan was rushed via ambulance from Marshalltown to the University of Iowa Stead Family Children’s Hospital to have an external ventricular drain (EVD) placed into his head which would allow the CSF to drain, and thus reduce the ICP.  Evan underwent this surgery within 30 minutes of arriving at the hospital in Iowa City.  After the surgery he was kept under sedation and remained on a ventilator to make it easier to capture a high-contrast MRI of his head. 
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<div>Following the initial MRI it was determined a second MRI was needed for his spinal cord to look for any additional tumors.  This second MRI was performed 24 hours later, after which he was able to have the sedation and ventilator removed.  This occurred around 12:30AM Saturday, November 9th. 
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<div>Removing the tumor
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<div>               After many discussions with several teams it was decided to remove as much of the tumor as possible with open surgery on Wednesday, November 13th.  Unfortunately there was no way to know the exact type of the tumor, how it was attached to the surrounding tissues, or confirm the diagnosis without an open resection.  It was estimated that the surgery would take over 12 hours. 
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<div>Thankfully the total time for the surgery was around 6 hours.  The surgeons were able to remove all of the tumor that they could physically see using a high-powered surgical microscope.  A biopsy was of the tumor was analyzed and the diagnosis was confirmed: Medulloblastoma. 
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<div>The small part of Evan’s skull that was removed for the surgery is being held in-place with titanium plates and screws.  The muscle in the back of the neck and head were sutured and will take the longest to heal and likely cause him the most discomfort, but overall shouldn't be too painful. 
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<div>The diagnosis
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<div>               Medulloblastoma is one of the most common types of brain cancer in children ages 8 and younger.  Its mutated cells easily travel throughout the brain and spinal cord via the CSF, and thankfully only affect brain and spinal cord tissue.   It’s difficult to estimate how long this tumor has been growing. Click here to learn more about Medulloblastoma. 
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<div>Post-Op Treatment
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<div>               Tentatively Evan will have a central-line tube surgically placed in his upper-chest on December 2nd.  After this procedure he will also have a sample of CSF extracted via a spinal-tap lumbar-puncture while he is still sedated. 
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<div>After confirming the tube placement with an x-ray and analyzing the CSF Evan will begin a series of radiation therapy (photon-based, x-ray) which will last for 30 days (excluding weekends).  Lower exposure therapy will be used on Evan’s head, and spinal column, followed-by a much higher intensity focused on where the tumor was resected. 
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<div>Following the radiation treatment Evan will undergo several weeks of chemo therapy which will be administered via the central line/tube. 
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<div>Finally, after completing all of his treatments he will have several tests performed every three months for the first year, then every six months for the following year, etc…
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<div>The Risks
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<div>               Honestly, the list of risks and side-effects are simply too difficult to list/explain at this time.  There is plenty of literature available online about the diagnosis, radiation therapy, and chemotherapy.   Evan is an exceptionally strong little guy and we will continue to pray and support him throughout every step of his treatments. 
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<div>The Outcome
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<div>               We know Evan is in the right-place for his overall health and cancer treatment.  With such a successful resection surgery, radiation therapy, and chemotherapy Evan’s prognosis survival rate is 80%.  Which is a true blessing!  We know this is going to be a long and difficult journey, but with the strength of family, friends, and Evan’s unfettering fight, we pray and believe he will be a survivor and will celebrate a long, healthy life. 
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<div>How can you help?
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<div>               Any type of donation, no matter the amount, will go towards Evan’s health, treatment, medical expenses, and well-being.  Including the extensive amount of travel and lodging Evan and his family may incur during these difficult times. 
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<div>Lots of friends, family, and the hospital have been providing as much help as possible.  Everything from financial donations, to food, lodging, babysitting, transportation, and care-giving for the entire family.  We thank all of you from the depths of our hearts for your support.  Even the smallest things like a conversation or a simple ride to/from school helps more than we can begin to explain. 
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<div>Updates
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<div>               Updates will be added as frequently as possible. 
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<div>Contacting the Family
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<div>               If you want to reach-out to the family you may contact either Matt  or Dana  via email.    
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Help the Krueger Family beat Brain Cancer!!

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