6-19-09 Appointment

Today is the 2nd Chemotherapy for IM (Interim Maintenance). He will be given IV Vincristine & Methotrexate thru his PICC. For each treatment, the dosage of MTX increases and is COUNT dependent. To receive any treatment his ANC should be greater than or equal to 750 and 75,000 platlets. BUT if his numbers are low, then the MTX will NOT be increased. His counts are all good so he received a higher dose of MTX. Common side effects are mouth sores & nausea. They gave him zofran tablet prior to the Chemo. But since it's crushed tablet, I don't know if he took anything in.

We also saw Dr. Freyer today. We have not seen him for almost a month so he was really surprised that Chase still have a full head of hair. He said that only 5% of the kids with the same protocol have hair at this point of therapy. We asked him what the indication is & he told us that it does not have any impact on the outcome. Well, that's good to hear. I am wondering why he always belong to the special category. I still hope & pray that he does not fall to the small percentage group that relapses.

We also talked about replacing his PICC line with a Port-a-cath. This device is placed under the skin, in upper part of the chest. It has a small reservoir that is connected to a major vein inside the chest. This device facilitates administration of chemotherapy into the venous system. It still has risks of infection but less than PICC. It requires surgery. But, no flushing and dressing change needed. He can also take a normal bath & swim. Chase will have this surgery sometime July at the same time as his Lumbar Puncture. Also, Dr. Freyer said that it is better to do it sooner rather than later because the next stage of his treatment is "Delayed Intensification". The name says it all.

No NG tube too! Dr. Freyer wants us to still try giving him meds orally and hope that he gets used to it before he takes oral chemo again.