We are at a stage in Alex's treatments where the duration and intensity of the chemotherapy has taken a toll. We give you chemotherapy, you recover. We give you more and you recover. We give you a lot more and it takes a little longer but you recover. And then some more. And after a while the recovery takes longer. Par for the course.
That's where I think we are now and for the next (?) couple of weeks Alex's blood counts will be watched closely.
Alex had a blood transfusion last Wednesday when his haemoglobin had dropped to 75. It was checked again on Friday - mostly to see whether he would need blood again over the weekend - but it was a not so bad 95 so we just had the Ara-C on Saturday but were told to come back on Tuesday (yesterday) to check again.
Thanksgiving Monday was such a fabulous day but Tuesday was ... back to reality. Alex didn't feel great, probably fatigue from the day before and the fact that his haemoglobin proved to be back down to 85. (normal = 125-165)
This is also a key time for platelets. A normal platelet count is somewhere between 180 and 440 parts per something (it's times 10 to the power of nine per litre if you really want to know). A week ago Wednesday Alex was at a strapping 212. His platelets have been quite strong. On Friday they were down to 170 and yesterday were 76.
As we were going to be back in today, no action was required yesterday. But today ... yes please.
Alex's heart rate was 140 when first checked at the hospital early this morning, a classic symptom of low haemoglobin. (There's not as much, so the body just pumps it around faster to get the job done, an amazing machine, the body) Another symptom is you look as white as Caspar the Ghost and all the docs you walk past down the hall coming out of rounds say "Hey, guess you're getting blood today, eh?" Probably a clue if you are as finely attuned to these nuances as I am.
Dr. L predicted 69, I thought 79 but said 81, with some home team bravado.
It was 72. Well. Hey, she did go to medical school, gimme a break here! And platelets were down to 57. From 212 to 57 in a week. Hmm. Par for the course though, this is expected. (Starting to get the meaning of the title now ain'cha?).
So, a big day again today. Alex received a shot of Vincristine and the dreaded "peg." You may recall this is a simultaneous injection of Asparaginese with a big needle in the thigh muscle of each leg. It is not well received by kids. I don't know if they do it to adults, but I'm sure we wouldn't like it much either from what I can see. Alex didn't even make a sound. You play hockey, you have a second degree black belt, what's a tent peg in each leg? Proud of that boy... I know he felt it though.
After Asparaginese, you have to wait for three hours to make sure you don't have a reaction to it before you can get blood. Alex killed part of that time by inhaling Pentamadine through a ventilator kind of thing for twenty minutes, a drug he needs once every four weeks to prevent a type of pneumonia. It tastes awful and it's an altogether unpleasant experience.
Once the three hours was up, he could get the blood transfusion, which took another three hours to drip in. Long day and he was exhausted long before we got home. The chemo has a had a temporary victory over the anti-nausea drugs and he has been very sick this afternoon and into tonight as I write this and I expect a pretty quiet next 24 to 36 hours.
We have tomorrow off and are back at the hospital on Friday to check the blood cell counts. The red stuff should be okay but he will likely need a transfusion of platelets.
(Quite a while back in response to so many people asking the same question "what can I do to help?" I wrote that giving blood was a great thing to do. It is, but giving platelets, which takes longer, is an even better thing to do.)
We have been at the hospital for 10 of the last 13 days now and 14 of the last 18. If I have counted correctly. I do know I keep wondering why I'm buying gas all the time! If you haven't seen me around much, that's why. Someone should please tell the Lions Pub that I'm okay.
In capital market parlance, my take is that we are forming a bottom here. Maybe not and I don't want to jinx anything, but we have to be close. It's no fun at all at the bottom (and it's a long, long way back up) but, this is hard to articulate and you never know until after the fact, but somewhere near here, you strangely start to feel more optimistic. Sometimes you're wrong. Sometimes you're right and I'm not sure, it might be a mirage, but I could have sworn a saw some light down at the end there somewhere. Is that the Phoenix capsule coming?
