Joshua went for his 2nd Echo Cardiogram today, which is basically an ultrasound of the heart. Nikole is always my shadow and likes to go with us. The reason for the echo is because the chemotherapy drugs can cause damage to the heart called Cardiotoxicity. As a result of the cardiotoxicity the heart is not able to pump blood through the body as well and if the condition becomes severe enough, it eventually leads to Cardiomyopathy. So basically the all chemo drugs can cause injury to the heart muscle disturbing the function and pumping action and subsequently leading to heart failure, unfortunately there are some kids that end up with permanent heart damage. The good news is that in comparing the first echo to the second one, so far Joshua doesn't show any signs of diminished heart function!