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Week 15

rev.dennis

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This week isn't about the chemo but more about a big Tuesday appointment where Kate will move

from a PICC line

picc-in-arm.jpgchemo-picc-line-101.jpg

to a PORT

CancerTreatmentPort.jpgchemo-port-101.jpg

as well as get an Bone Marrow Biopsy / MRD Test.

What is an MRD Test?

Measurable or minimal residual disease (MRD) testing is used to see if the cancer treatment is working and to guide further treatment plans. MRD testing is mainly used in blood cancers (leukemia, lymphoma and myeloma), but is being studied in other cancers. It is a type of personalized medicine, because the results can be used to tailor your treatment plan.

What can the MRD test find?

This test can find even the smallest amount of cancer cells that may be remaining after treatment. This can:

  • Show how well your cancer has responded to the treatment you received.
  • Do a better job of finding out if you are in remission than other tests.
  • Find a cancer recurrence sooner than other tests.

MRD tests use highly sensitive methods, including multi-parametric flow cytometry and polymerase chain reaction (PCR). These methods look for any remaining cancer cells that cannot be seen in routine tests. This test can detect even 1 cancer cell among 1 million normal cells.

MRD testing is also useful in clinical trials for new medicines. MRD can show how well the medicine is working at treating the cancer without having to wait months to see if the cancer returns.

MRD and ALL

  • Part of routine testing in the treatment of pediatric and most adult ALL.
  • Can detect relapse earlier than other tests. This allows for earlier treatment if relapse is suspected.
  • Studies show that MRD is the best way to predict what treatments will be most helpful after the induction phase ALL treatment.
  • MRD can also help identify patients most at risk for ALL relapse. These patients may have the best chance for a cure with a bone marrow transplant. Patients with good MRD response may be able to avoid transplant. 


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Bloodwork Results

  • Potassium: 
  • Bilirubin(Liver Function)
  • White Blood Cells (WBC 4.0-10.0): .
  • Hemoglobin (HGB 11.5-16.0): 6.8
  • Platelets (PLT 150-500): 100

Transfusions

  • Blood: YES
  • Platelets: YES/NO

Procedures

  • Lumbar Puncture: YES/NO
  • BoneMarrow Biopsy: YES

Chemo

  • Daunorubicin via Syring (avg 5min infusion): YES/NO
  • Vincristine via IV drip (avg 5min infusion): YES/NO
  • Pegasparagus via drip (avg infusion): YES/NO
  • Cyclosphomine: YES/NO
  • Cytarabine: YES/NO
  • Rituxan via IV drip (avg 4hour infusion): YES/NO

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Kates out of surgery and all is good. She’s weak in the knees and in pain/sore but she does enjoy not having the PICC line anymore.

She is still very much raving on how awesome Dr.Yang is to her and how attentive he is to every detail.

more to come later

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Today is a rough day for us. Last night our furnace went out so no A/C on a day that was up in the high 80s. Shutz Heating and Cooling is suppose to call me first thing this morning.

Kate woke up with a fever of 102.8 at 7:52am so we have a wash cloth and Tylenol at 8am.  Checked it at 8:02am and it came down with a cool washcloth mainly to 101.3

Going to keep monitoring every 10min until it gets down.

i need to get our A/C back. I think we have a blown thermostat (comfortlink ii xl1050). We love our trane furnace but the weak link seems to be either the relay panel or the thermostat.  Of course we have a very old A/C unit. Hope that’s not out since we don’t have the funds for that.

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8:21am 103.1 and called the radiologist and left a message as directed to do by paperwork she was given.  Pain medication isn’t working and she has a fever.  I predict us having to go to hospital.

we double checked with two other thermometers and the Vick’s oral and Braun ear seem consistent. Our new infrared forehead thermometer IR 988 says she doesn’t have a fever. What a piece of garbage. Checking on a refund/return on this crap.

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8:31am 102.4 (we will continue to monitor for a little bit more. If not down in next 10min I have to get her dressed somehow and get her to the vehicle)

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Just dropped Kate off at the Emergency Room at Harper Hutzel hospital. Dr.Yang called at 8:42am after I left him a message and he recommended I bring her down for some antibiotics since her white blood cell count is so low it may not be enough to fight any infection.

So now I need to find a trane furnace repair tech that will come out. Both Schutz and Affordable both don’t have appointments until end of next week. My backup plan is pull RV right next to house with generator and run the A/C so she can keep her cool until we get the A/C fixed

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So last night they did get kates temp to stabilize with more anti-biotics and fluids.  Also our friend Kevin hooked us up with a great HVAC repair man which we will always use now.  He got us up and running (found a short).

Now we work and wait for the request to go pick her up from the hospital.

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Well leaving today was a no go. Fever is under control but they think I have a skin infection from the port placement. That means I spent another day in the hospital alone on antibiotics. Dennis was sweet enough to drive back down here and bring me some stuff since I wasn’t planning on being admitted yesterday. Fingers crossed I can get out of here tomorrow.

i had to get another blood transfusion today but other than that it’s been mostly antibiotics and painkillers. 

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