Time flies; tomorrow is already Noah’s last chemo treatment of round 4. No real surprises thus far and he’s doing well. He had a couple days pretty down for the count, but has had some energy and no nausea the last couple days.
We started the round on Tuesday and got labs prior to his first chemo treatment. Hemoglobin was solid at 11.8, platelets at a very normal 348, and ANC at 2,142. That ANC is the highest we’d seen it during non-chemo days (some medications can give deceivingly high counts) since before he was first admitted. All in all, a nice starting point.
Round 4 (Intensification 2) consists of 6 days of chemo treatments. As has been the case with every round, our old friend (and foe) cytarabine is part of the plan. For the first four days, he received a high dose of that over three hours, twice a day. High doses of cytarabine can cause a number of eye issues so he received prophylactic eye drops every few hours to decrease that risk.
Starting on day three, he received a new medication: mitoxantrone. This is somewhat similar to the daunorubicin from earlier rounds and requires a heart protectant prior to its delivery. The good thing is that all of this is pretty quick. The heart protectant (dexrazoxane) is delivered over IV within about 15 minutes. Once that’s in, the clock starts on getting the mitoxantrone delivered within 30 minutes. Also, this one is only every 24 hours. On days 3 and 4, he received both cytarabine and mitoxantrone, and then just mitoxantrone these last two days of treatments.
Everything we’ve heard is that round 4 can be long to very long. We’ve heard a few more common data points from 7 to 10 weeks, but even extreme cases in this very hospital of 6 months or so. I have no reason to think we’ll be on that extreme end, but are prepared to settle in for longer than the other rounds. Regardless, our doctor has been clear that this is “heavy” chemo so it would make sense for the counts to take longer to recover.
I talked about facility issues a good bit in the last two posts, but Noah was excited to get back into the same room we had at the end of last round. He likes it mostly because it has a TV embedded in the ceiling tile :). If you’ve got to spend a couple hundred days in a place it’s nice to do it amongst this caring and talented staff. Somewhat hilariously, the first day we were here the heat wouldn’t shut off in our room and it turned into a sauna, but they got that fixed up so all is well.
We’ll be done with this round of chemo by 11am tomorrow and then we wait. Counts have started dropping; hemoglobin 8.9, platelets 163, and ANC 1,428. It won’t surprise me to see us nearing the transfusion ranges for hemoglobin and platelets and ANC nearing zero within the next few days.
That’s all I’ve got for now. Noah is re-watching all the more recent Spiderman movies. We watched Spaceballs last night and I pushed for another Mel Brooks flick, but perhaps I should wait on most of that catalog of movies anyway. As always, we love you all and over and out.
