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This week Kate is taking antibiotics for the fever she was having previous week and this antibiotic is making her feel very sick (like the vomiting sick) but she should be done with the antibiotics by Friday at the latest. Also she is fighting neuropathy in her feet now where before she was just experiencing it in her hands. The doctor said this is an expected result from the Vincristine chemotherapy drug. What is peripheral neuropathy? Peripheral neuropathy is a blanket term for pain and discomfort and other symptoms that result from damage to peripheral nerves, which are the nerves that extend away from the brain and spinal cord. The peripheral nervous system carries signals from the brain and spinal cord to the rest of your body, and then returns nerve signals from the periphery to be received by the spinal cord and brain. Any problems along the way can affect the skin, muscles, and joints of your hands, feet, and other parts of the body. Many things can cause neuropathy, including certain chemotherapy drugs. Damage to peripheral nerves by these drugs is called chemotherapy-induced peripheral neuropathy, abbreviated as CIPN. CIPN isn’t uncommon. Of people with cancer who are treated with chemotherapy, about 30 to 40 percent develop CIPN. It’s one of the reasons that some stop cancer treatment early. What is the plan for this week? Thursday we go down for a quick follow up with the Infectous Disease doctors to make sure she is okay and maintain no fever. Friday is her big day that we will be down in Detroit most of the day.
During the time you are fighting cancer (especially A.L.L.) you will have to received several Lumbar Punctures or also referred to as Spinal Taps. So what are they? Lumbar puncture, also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid for diagnostic testing. The main reason for a lumbar puncture is to help diagnose diseases of the central nervous system, including the brain and spine. A lumbar puncture (spinal tap) is performed in your lower back, in the lumbar region. During a lumbar puncture, a needle is inserted between two lumbar bones (vertebrae) to remove a sample of cerebrospinal fluid. This is the fluid that surrounds your brain and spinal cord to protect them from injury. A lumbar puncture can help diagnose serious infections. Sometimes doctors use lumbar punctures to inject anesthetic medications or chemotherapy drugs into the cerebrospinal fluid.
So we got up at 5am to get our butts moving for our 7:15am scheduled appointment at Karmanos Cancer Institute in Detroit. Our actual appointment isn’t until 7:45am but they tell us to arrive 30minutes early which translates to someone in the military as 6:30am arrival time as Kate and I are hanging out in the parking garage. Our boys had to help us out this morning by getting themselves ready for school and Alex has to get himself on the bus. So this is our 2nd Chemo treatment as part of the 4 week Induction Process before they begin the aggressive chemo treatments. We aren’t sure what that will entail but we know it is the same process they perform on kids with a higher success rate than an adult treatment. My worry for this week is how Kate’s blood count will do being not monitored for a week. We know after last week that her count for hemoglobin and platelets and white blood cell count all decrease pretty quickly. I just don’t believe she will be able to go a full week without a blood transfusion. I suppose a question for Dr.Yang when we see him today.
We are at the Karmanos Cancer Institute in Detroit for our 3rd Chemotherapy Treatment as part 3 of 4 of the Induction process. This week they are introducing Rituxin to the normal two she has been receiving. It appears Rutuxin has less side effects as the new drug they used last week so that is good. Especially since I'm on-call starting Tuesday to Tuesday so I will be concentrating more on my job. If we take last week as any indication on how busy On-Call has been, I'll be busy every night but very lucky to have such a great company to work for as they have been understanding and working with me through this tough time in my life. 7:15am In waiting in the waiting room to be called back 7:45am Took us to Room #6 where they took her weight, blood pressure and took 5 test tubes of blood (green, pink, yellow, purple) 9:00am Received the results from bloodwork they took at 7:45am. Most numbers are good (except White Blood Cell count) Potassium: 3.9 White Blood Cell (WBC): 0.4 Hemoglobin: 8.8 Platelets: 79 9:15am Got our visit from Dr. Yang. He said all was good. He wants to keep an eye on liver numbers which are high but expected after the pegaspargase Kate received last week. He also mentioned he would send a prescription for Ambien to help Kate sleep a full night since she isn't currently which they believe is the result of the steroids which she just needs to take for these last two weeks of the Induction phase. He mentioned that the Tuesday with no chemo she has to get another bone marrow biopsy to see how the treatment is progressing. He also said that the corona virus that is spreading like widfire could really cause some significant issues so be very cautious about being around anyone sick, especially with the white blood cell count so low. Kate should still be excercising/moving around but not around people mainly as much as she can, stay home and away from anyone sick. 9:35am Nurse begins the process of the pre-drugs Two Regular Tylenol via pills Benaryl via Syringe Hydrocortisone steroid via a Syringe 10:00 am Nurse is starting the Zofran IV drip (avg 30minutes) and yes, Kate is getting very sleepy. This time we got a room with a hospital bed versus a chair. I see ZZzzz's in kate's near future. next will be the 2 normal chemo drugs and the rituxan. First two take about 5min each and the Rituxan takes 4 hours minimum. 10:30am Kate received the daunorubicin via Syring (avg 5min infusion) 10:40am Kate began receiving the vincristine via IV drip (avg 5min infusion) 10:55am Kate began receiving the Rituxan via IV drip (avg 4hour infusion) - NEW 11:15am Nurse woke Kate up from a pretty deep sleep to check her vitals. You could see how unpleasant Kate was with that sleep interruption. 12:30pm Kate is awake, I got her some apples and caramel and she is watching her shows and just ordered some chicken and dumpling soup. Everything is moving right along. It doesn't even look like the Rituxan IV bag is even going down but I'm sure it is.