9-14-09 Appt.

Actual Date: 09-14-09
We finally started the next phase of DI last Monday. Chase was scheduled for an LP and received a new chemo called Cytoxan. We were there before 8 am. His labs are good. ANC was over 1000. Chase was called into surgery a little bit after 10. This was a great improvement from the last schedule. They started his IV fluids in the recovery room. Nurses mentioned that he needs to have 4 hours of IV fluids before & after the Chemo. They will check the gravity of his urine prior to giving the chemo. They will not start it unless he is fully hydrated. And since he was without any food & water since midnight due to his surgery, he needed a lot of fluids.

We have 2 chemo's to give at home. Ara-C that is injected to his port and 6-TG, a pill taken by mouth. They left his port access open this week. Before ARA-C, we need to give him zofran for help with nausea. It is also a pill. But, it dissolves in mouth. We were never successful with this pill in the clinic. It always lands on the floor. The nurse taught us how to administer the ARA-C. It is similar to flushing the port. But, I need to push the chemo for over a minute. 6-TG should be taken on an empty stomach. Should be given 2 hours after a meal and no dairy products within that time as well. Also, no meal or dairy after 1 to 2 hours after. We left the clinic at 8PM. The last one out again & the longest stay so far.

What to expect on this phase:
Low Blood Counts
Fatigue
Loss of Appetite

We are hoping no fever this time.

We're home

His ANC went up to 230 today. We're home. Chemo for this week is cancelled due to his low ANC. He's still eating a lot and is sleeping more. We'll have to wait & see what the next phase entails.

Update

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We are hoping to get discharged tomorrow. His ANC today is 80. So, it looks like it is on an upward trend now. He was feeling great the whole day too.

We cut his hair too. It was making so much mess.

Still here. ANC=20

Can't seem to get rid of that number. We were hoping that his ANC has climbed up today. But, it stayed at 20 like yesterday. If you think of it, it did not go down. So, might be a good sign that it will trend up tomorrow. He had a low grade fever last night & this morning.

We are also out of the BMT unit. This afternoon, we were transferred to 4 East when a room has opened. Room 413East. This was the same room we were at in the beginning. The room where we cried finding out about his diagnosis. I'm having flashbacks.........

We're anxious to find out tomorrow's number. I will update again.

Photo taken 9-5-09

He's close to being bald. We will shave it off when get home.

It just looks messy right now.

9-5-09

Update from this morning. ANC= 20. It is almost zero 0. It means Chase is very neutropenic. He cannot fight infections, if any. They will still keep us in the hospital.

What is neutropenia?
"Neutropenia" is a condition in which the number of neutrophils in the bloodstream is decreased. Neutrophils are a type of white blood cell also known as polymorphonuclear leukocytes or PMNs. Neutropenia affects the body's ability to fight off infections.

How is neutropenia defined?
The white blood cell count (WBC) is the number of white blood cells in a volume of blood. The normal range for the WBC varies slightly among laboratories but is generally between 4,300 and 10,800 cells per microliter or cubic millimeter (cmm). The WBC can also be referred to as the leukocyte count and can be expressed in international units as 4.3 x 109to 10.8 x 109 cells per liter. The percentage of the different types of white blood cells in the WBC is called the WBC differential.
The absolute neutrophil count (ANC) is determined by the product of the white blood cell count (WBC) and the fraction of neutrophils among the white blood cells as determined by the WBC differential analysis. For example, if the WBC is 10,000 per microliter and 70% are neutrophils, the ANC would be 7,000 per microliter.
An ANC of less than 1500 per microliter (1500/microL) is the generally accepted definition of neutropenia. Neutropenia is sometimes further classified as:
mild if the ANC ranges from 1000-1500/microL,
moderate with an ANC of 500-1000/microL, and
severe if the ANC is below 500/microL.

9-4-09 The Plan

Today, were told that we will be released on the following conditions:
1. No fever in 48 hours
2. ANC count is on rising trend


We got the first condition resolved. Just waiting for his ANC to go up.
However, when we received his ANC today. ANC=100. It was 20 pts. lower than yesterday.