If you don't want all the details you may just want to scan through the pictures because this is a long one......
Chase had to make counts to go to clinic this last week. He didn't make them the week before to go on Jan. 6th. His ANC was only 300 which is super low. We don't really go anywhere anyway, but we made sure that we were super careful washing hands and such. So he had to be 750 and in the past he has come up maybe 100 in one week so I thought there was no way we would be going this last week either. So it is the first time that I did not pack. Of coarse I get the phone call saying that he made counts and his ANC was 1200! That one of the highest he has ever had and after being super low the last week I almost made them check twice. So we QUICKLY packed because I had nothing done, and we got on the road by 1:00. Record time packing because I didn't find out until 11am that we were going. Two hours and I was ready. I have to say I am getting quite good though because when you do something almost every week how can you not be good at it right?
Chase's apt was at 12 noon with and RTU to be sedated and get a Lumbar Puncture at 1:30. This means he gets no food until probably close to 2:30 and maybe even 3 depending on the medical world that is always behind. I hate doing this to Chase because even though the steroids have worn off I am pretty sure he is in the middle of a growth spurt. He eats all day long. I didn't know how I was going to hold him off that long. I called the clinic hoping for a better time and that someone had canceled. She put me on hold and came right back to say there was an opening at 10am and she would see us in the clinic at 8:30am. This made may day!
We were pulling into SLC around 6pm when I got a phone call from RTU. They always call to ask questions about Chase and to tell me diet instructions. When she said that he could have clear liquids until 10:30 I stopped her. "NO, his apt is at 10." I said.
"I am sorry miss, but I just printed the final schedule and he is at 1:30"
I was not too upset with her because it was not her fault, but who didn't call me to tell me this? I now have a clinic apt at 8:30am and don't have to be to RTU until 1:30. What do I do to stall him and distract him from eating for that long? The nurse from RTU said we could just hand around the hospital. Okay, thanks lady but that is the last thing I want to do. I am scared to death of germs and you want me to hang out for 5 hours at the place people come when they have germs. I don't think so. The problem was that clinic was closed and there was no way to change my 8:30am so I had to go at that time. I still had him fasting for a morning apt. just hoping there was a mix up somewhere.
Doing crafts in the waiting room!
When we got to clinic Sandy (the lady up front) apologized before I could even say anything because she knew how upset I was going to be. I asked about the sedation suite. This is a little room upstairs by the clinic. They don't totally knock the little kids out. They give them Versed (Midazolam is given to children before medical procedures or before anesthesia for surgery to cause drowsiness, relieve anxiety, and prevent any memory of the event. Midazolam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow relaxation and sleep). They also gave him Ketamine (Ketamine has a wide range of effects in humans, including
analgesia,
anesthesia,
hallucinations, elevated
blood pressure, and
bronchodilation.
Ketamine is primarily used for the induction and maintenance of
general anesthesia, usually in combination with a sedative).
They told me that he would not be all the way out and his eyes would stay open but bounce back and forth a little. This they did, but one nice thing about it was I got to stay in the room with him. In the RTU they make me leave him there and it always makes me so sad. I was holding him and he was crying when they started giving him the meds. Once he got a little in his system the crying instantly stopped. I think the hallucination part kicked in because he looked up at me (with just his eyes, his head and neck did not move) and he just giggled. He was feeling pretty good at this point. They tried to poke him once and he flinched and then reached back for the needle in his back. That is when they knew he needed a little more drugs. They gave him a little more and tried again. This time he flinched but never cried or moved his arms. I got right down by him and held his little hands and talked to him. He was so cute because I would tell him he was AWESOME and he would say in his sweet little voice, "ah-hu!" He knows he is awesome. The doc told me that when I talked to him he seemed to relax and he could get the spinal fluid. When I was not talking he would tense up and nothing would come out. I liked knowing that I was there to comfort him even though he would not remember any of it. He is my little trooper and I love him.

After the LP and while he was waking up I ran down to the pharmacy to have them show me how big the new oral chemo was that he was going to be taking for the next two weeks. I was a little worried when they showed me. It was about the size of an adult tylenol, but I knew he was great at swallowing them and would rather do that than have some nasty syrup so I opted for the tablet. I told them I was going to fill in in St. George though so I wouldn't have to wait for them to fill it there. I headed back up to my little boy who was still groggy and hanging out with the nurse.
After he was a little more with it we headed back over to infusion to get the dreaded and much needed chemo. He had a new one today that had to be infused over an hour so we still had lots of time. Chase wanted food of coarse so we ordered him a cheese pizza, grapes, and some teddy grahams. He was loving it. Nothing like some good pizza when you have been starved to death. He did great and after eating was up and playing with the little kitchen that the cutest little girl next to us had out and he couldn't just sit there and watch.
Still kinda out of it.
Lovin' his pizza.
I was feeling pretty good about the day because we didn't have to do the 1:30 RTU and got out of there close to 1:30 instead of 3:30. We were just getting on the 215 when I got a phone call from the St. George Pharmacy at Harmons and she told me they didn't have the oral chemo that we needed. I had this gut feeling when I told them I wanted it called in down here that that was going to happen. I should have went with my gut and got it at PCMC. Oh well, lesson learned. So I told them to call PCMC pharm and get it started there. I went out to Holladay to get Ashton's mom who was at the place we stay hanging out with Mason (BTW - she is awesome if I haven't already told you that. With out her and my mom there is no way I would have mad it through these last 6 months). We got all packed up, went and grabbed some lunch and headed back up to PCMC. Yes, we did a lot of back tracking but that is what you do when you have to have the drugs!
Chase did great the whole way home. They just kept telling me that this one REALLY makes you nauseous, and I just kept thinking "not Chase!" But at the same time really hoping that I was right. Well, we are now on day four of the chemo and he has not thrown up once.
They sent us home with a RX for 6TG which is an oral chemo and left Chase accessed (he still has the tube coming out of his chest). I have to give him chemo at home for the next three days. They will come again on Thurs and access him again and I will do it again for the next four days. I am loving it though because that means I do not have to drive up to PCMC again for another month or even longer. This was good news to me because I thought we were going to have to go every week this month. Our next apt will be the beginning of Maintenance which is a phase that last for three years. Although he still has to have chemo those three years it is usually more stable and they keep his counts up higher so he can live a somewhat normal life. So as you can see we feel like we are starting to see the light at the end of the tunnel. It is a long tunnel, but one that I am expecting to be more normal and straight instead of crazy and unplanned.
So the at home chemo is going well. It is crazy how much stuff is needed to give one little med. It is scary how it is treated like it is poison because that is exactly what it is. They brought me out the gown, chemo gloves, spill kit, and the big yellow CAUTION CHEMOTHERAPY box to put the waste in when we are done giving it. I have always had a love hate relationship with the stuff, but it is different when it is brought into my house. Abby was just touching the yellow box and I found myself yelling at her to get away. I felt bad afterward and had to explain why I yelled, and then she immediately went to the bathroom to wash her hands. She was then concerned also, I just had to take the time to tell her why. It also makes me nervous to handle the stuff and then right after pick up Mason because he screamed the whole time I was giving Chase his meds. I feel like I am contaminating him even though there is no way because I am suited up head to toe when I am doing it.
This is the "fun" package I got from home health.
The "poison" that I have to give my son.
The bag the chemo comes in.
Chase is giving himself his own medicine. (This is just saline. There is no way I would let him do the chemo). I had turned to get the zofran (anti-nausea) and when I looked back he was finished with the saline and was pulling back on the syringe like the nurse does to get blood. He said, "hey look, red juice mom!" My child just drew his own blood....AHHHH!
We can't do smiling faces we always have to do crazy faces.
I said, "let's smile this time." And this is what he did.
Today was our last day of chemo at home until thurs. so I had to de-access him (Chase would say take out his tubey). He hates this because the dressing is super sticky and pulling out the needle must hurt a little because he HATES it. He did so good today all except when I pulled it out.
Chase's counts this week were:
White - 3.8 (this is high for Chase)
Hct - 32.8
Platelets - 293
ANC - 1200 (also high for Chase)
They told us to expect these numbers to hit rock bottom this month. We will probably be in the hospital for blood transfusions and such, but that can all be done down here at Dixie so I was pleased about that.
Here are the meds that he has these next two weeks:
Thioguanine (6-TG which is an oral chemo)
The side effects of this are Mild Nausea and low blood counts with less common mouth sores and abnormal liver function tests.
Cyclophosphamide (cytoxan this is an IV chemo that was given for 1 hr at the clinic)
The side effects are Nausea/vomiting, loss of appetite, hair loss, low blood counts 1 to 2 weeks after treatment. Less common is blood in urine (bladder irritation....they told me to have him drink a lot and change his diaper a lot. They also gave him a full bag of fluids to help flush it through his kidneys faster).
Metal taste in the mouth, hormonal changes, and heart damage with high doses.
Cytarabine (Ara-c is and IV chemo that he got at clinic and we give him at home)
The side effects are Nausea, vomiting, loss of appetite, diarrhea, low blood counts 1 to 3 weeks after treatment, mouth sores. Less common is hair loss, abnormal liver function tests, irritation to the eyes with higher doses, flu-like symptoms (fever, aches, fatigue). The nurse said the fever can get up quite high and we still have to go to the ER and get fluids, antibiotic, and cultures even though it may be from the chemo. We are always so paranoid and already carry the thermometer with us everywhere we go. This week poor Chase has had it stuck in his ear more times than I am sure he would have liked us to. But he is still happy and wants to know what his numbers are after it beeps. He amazes me every day!
All that playing can catch up to you in a hurry. Especially when your body is being killed by chemo at the same time.
He didn't wake up so happy either. But after a while he is up and running again!