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Week 1 (Induction Phase)

rev.dennis

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It’s 3am on 2/17/2020 and we are in a room on the 9th floor in Karmanos Cancer Facility in Detroit.

This is the beginning of the Induction process which in short means the beginning of chemo treatments while keeping a close eye on Kate during the process.  The doctor believes this will take less than a week this visit but the Induction process is typically a week.

There are four phases to chemotherapy treatment:

  • The first phase is called Remission Induction. Treatment during this phase is designed to kill the leukemic cells in the blood and the bone marrow, putting the disease into remission.
  • The second phase is Central Nervous System Directed Therapy. This phase kills cancer cells in the central nervous system and prevents the disease from spreading to the spinal fluid.
  • The Consolidation/Intensification phase is given after the disease is considered to be in remission. It's designed to kill remaining leukemic cells that may be inactive but could begin growing again and cause the leukemia to recur. This phase usually lasts several months.
  • The maintenance phase is the final phase of treatment that lasts for two to three years. It's used to kill any remaining cells that could cause a recurrence. Medications are often given at lower doses.

stay tuned for more updates



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that's what drove me crazy about when Kareta was in the hospital...one of us was always with her 24 hr & the traffic through the room was crazy. She'd fall asleep finally & then they come in & poke her some more. 
My thoughts & prayers are with you guys!!! Love you both!

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1 hour ago, Debbie said:

that's what drove me crazy about when Kareta was in the hospital...one of us was always with her 24 hr & the traffic through the room was crazy. She'd fall asleep finally & then they come in & poke her some more. 
My thoughts & prayers are with you guys!!! Love you both!

Thanks Debbie.

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So her hemoglobin dropped to 6.1 overnight (in less than 12 hours) so they are getting everything together for another blood transfusion (#6).  Today she'll also get spinal tap which will inject some Chemo into her spinal cord while they take a sample to test to see if the Leukemia has made its way into the spinal cord..  we are hoping it hasn't.

Dr.Yang is a superstar of a Doctor but seriously all of the doctors that we have encountered have been awesome.  Our least favorite area was the Harper Hutzel ER room (happy to be out of there).

They may take another bone marrow biopsy if Dr.Yang doesn't get back the results from the company they sent the bone marrow biopsy they took in Flint McLaren Hospital.  Dr.Yang doesn't want to delay treatment anymore so another bone marrow biopsy is a possibility and he can get the results next day to find out if she is Philadelphia chromosome positive or negative which dictates what ingredients need to be in the chemo treatment.

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Starting Blood Transfusion now... need to get Kate’s blood count up. Only numbers they are really focusing on is hemoglobin (They want above 7 and its 6) and platelets (they want in the 50’s and it’s in 30’s).

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E3D70FA6-7D02-4D11-90F7-2B3EC5CC61A2.jpegFinished transfusion just now and they are now moving into doing a bone marrow biopsy on left side since it was done on the right side.

also adding some platelets 

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Good news is they didn’t do a bone marrow biopsy but instead they did something where they just extracted some marrow which I think they called aspired.  So Kate earns her hashtag again #k8strong

they mentioned MRD testing, need to look that up.

next they are adding platelets and will do the spinal tap adding chemo in the spinal fluid at the same time taking some fluid for testing

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Kate just left to IVR (radiation) for spinal punch. The procedure is roughly 20-40minutes and then there is recovery. They do sedate Kate which she is looking forward to so maybe she could get some sleep.

dr.yang got some news from the bone marrow biopsy and they said Kate is Philadelphia chromosome negative but he wants to double-check since treatment is very important to know for sure. So the test he did earlier will give him those results in 24 hours.  He did say they are trying to get us a room on the 8th floor which is reserved for chemo patients. They do not want to start chemo until Kate gets on the 8th floor since the nurses here on the 9th floor don’t work with chemo.

now we wait for procedure.

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Keeping the prayers going...

Been thinking about you guys all day. Hope you're both able to get some sleep. 

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Just spoke to Dr.Yang as he made a visit on his way out for the day.

he recommends Kate lay as flat as she can when she gets back to the room for 2 hours preferable but 1 hour minimum.

he said there is no reason why they can not start chemotherapy tomorrow which will consist of two drugs for chemo and she will have to take one pill (steroid) orally. The steroid she will take daily and the two chemo injections she will do once a week. More than likely she will need another transfusion but the current tentative goal is go home Friday and come back Monday. Repeat process for a total of four weeks which would conclude the Induction process at which time they want to get more blood marrow to see if the cancer cells are declining.

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Kate got some food in her and now she’s fighting through some pain (with the assist of some pain killers) and maybe one more dose of pain killers before she tries to get some sleep.

im hoping to sleep on a cot or anything besides these chairs which are not comfortable.

i really need to thank our friends And family for helping take care of our dogs while we are gone. It’s a huge stress for Kate and I being so far away but everyone seems to be helping relieve the stress and I seriously can’t thank u enough.

it appear the remaining of our night will be hopefully uneventful so don’t be surprised if you don’t see anymore posts tonight (unless something negative happens).

good night

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Oncology nurses are the best! They will take wonderful care of Kate.  Once they get all the test results back and the doctors have the course of treatment laid out, the frequent interruptions will slow down. 

 

Thinking of you guys. 
 

 

 

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Good night. I hope Kate gets some sleep (you too Dennis). Keep fighting the Cancer. I know together you can beat it.

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we just got moved down to the chemotherapy floor (8) so now we are in room 8223

her hemoglobin is down to 7 so they are going to give her a blood transfusion.

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Kate got some sleep and woke up on her own at 4am because she had to pee. The nurses then did bloodwork to see if her hemoglobin is back up from 7.4 now that she had a unit of blood last night. white blood cells 1.3 (normal is 4-11) and platelets 35 (normal is 55+).

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Kate's fed, she took a tylenol 3 for pain (pill), allopurinol (pill), antiviral (pill), anti-bacterial (pill) and an anti fungal (oral liquid) medicine.  Now we wait for Dr. Yang to give us the game plan for today.

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internal_medicine.jpgInternal Medicine (3 doctors) just came in and checked to see how Kate is doing and feeling.  Sounds like Chemotherapy is still on the docket for today but we are awaiting Dr.Yang.  They checked on how Kate is doing with all the procedures she had done yesterday.  She is super sleepy and is passed out now but I think its a good thing.  I see its lunch time and I may sneak downstairs and get something to munch on.  I love chips but because of all the stroke victims in the hospital I lean away from them since its one of the major causes of a stroke. :(  Actually I have been trying to eat healthy so I can keep taking care of Kate but I may break down and get something non-healthy (meaning something with some flavor) today for lunch like a burger from Wendys.

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Dr.yang came in at the this time and gave us more information.  Results of lumbar punture (spinal tap) proved positive results (no cancer in spinal fluid).  He also spoke about treatment which includes:

the following once a week (every Monday as out patient):

  • daunorubicin (side effect: nausea, hair loss) - Syringe
  • vincristine (side effect: tingling in hands) - IV bag

*constipation is a worry with treatments so much the nurse and doctors ask every time they come in

the following every day for 28 days:

  • steroid: prednisone

may add another drug week 2 and another drug that is used on children week 3 (rituxan) which focuses on A.L.L.

he mentioned things to pay attention to while she’s home which is mainly infection (fever of 100.4 that lasts more than 30minutes she must come to ER).

mentioned chemo will reduce platelets which are optimum at 50k but at 30k now and we may notice bleeding when below 10k.

——

after Induction period (first 4 weeks) the chemotherapy gets kicked up a notch and is unpleasant and this will happen for 6 months and sounds like multiple visits per week.

..

Kates first chemotherapy treatment is coming soon (sometime this afternoon)

They gave Zofran (for nausea) and Prednisone (the steroid) today at 14:30

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at this time (15:12) kate received the daunorubicin via syringe. Nurse mentioned it is important for oral hygiene since it could create sores in your mouth. Also it will more than likely create red urine.  They are also giving the vincristine via IV.

COMPLETED adding the daunorubicin and vincristine at 15:30

 

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Kate is doing good.  She's groggy but doing okay.  Just brought her an ICEE (coke.. uh oh), grilled chicken bits from chik-fil-a and watching TV.

Shes not a fan of how she feels because its different than anything else she felt.  She is homesick... missing her puppies.  I'm saying she's emotional which the doc said a side effect of the medicine.

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They just put a bag of cefepime and a couple blue pills which we believe is antibiotics (fungal, bacterial, )

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Take care of yourself Dennis so you can take care of Kate. Nobody said fighting cancer is easy. Keep fighting and don't get discouraged. You and Kate will win the war.

 

 

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Bloodwork at 3am and then more antibiotics at 4:30am

unfortunately Kate didn’t get much sleep (which is another side effect of chemo). She’s also nauseous and did have tingling in her feet but she was able to work out the tingling.

visit from internal medicine at 7:30am to check on her status.

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