Tuesday, May 30, 2007

Reporting again from the hospital, Round 2 of chemo started today. For this round, we only have 2 days of chemo. We're a bit disappointed in that we were told we would be here one night, but now informed that due to the hydration required, we need to stay for 24 hours following the last dose of the chemo, which will be tomorrow around 6 pm. Cyclophosphamide can be very damaging to your bladder so it is required. So much for our one night stay!

We did start off today on a good note, Hannah gained .2 kilos, almost half a pound from just last Friday (thank you Aunt Kathleen for all of those donut animal games over the weekend.) Her doctor then proceeded to tell her that it's ok if she doesn't eat during this round of chemo. I wanted to stand up and stop him, but what he was trying to say was that if she wasn't feeling great, it's better not to eat or to only eat a little, rather than eat a lot and throw everything up. It's just so difficult though to keep her eating, I wanted to stop him. For lunch I bought her chicken from the cafeteria (her request), but she quickly dismissed it, and had a rice krispie treat and ice cream instead. Lunch of champions. She ate a dinner of pasta with butter and parmesan cheese and root beer and just kept eating and eating, I was surprised! Her counts are all up to:

WBC 2.24
ANC 1390
HgB 11.2
PLT 137

All of these are at the low end of the range, or slightly below, but still all acceptable.

She started her chemo today with a shot of Vincristine and a dose of Cyclophosphamide. Tomorrow she will also get a second dose of Cyclophosphamide. All has gone well so far. Vincristine belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants and Vincristine is made from the periwinkle plant. This drug works on cells are they are dividing and replicating. Inhibition ultimately results in cell death, thus not allowing the cancer cells to grow (or the good cells either, but that's the case with all these drugs, hence the low blood counts). This drug has many serious side effects associated with it. Although the statistics say that few kids get neuropathy and some of the other serious complications, I know of many kids that have experienced them. It's a wait and see-usually they show up within a week of the shot. This drug is also cumulative, so as we move forward in her treatment, we may begin to see other side effects.

Cyclophosphamide (Cytoxan) is the other drug this time, it is an alkylating agent. Alkylating agents are most active in the resting phase of the cell, before they divide. All cells divide during mitosis, but cancer cells lose the ability to stop dividing and grow uncontrolled.

As with all other chemo meds, they expect nausea, loss of appetite and low blood counts. She will also most likely lose what little whisps of hair she is beginning to grow in about 3-6 weeks. That's temporary though and will grow back.

The nadir for her counts will most likely be about 7-10 days out, probably bottoming out on her birthday (next Wednesday) or the following day. I'm really hoping that she feels well enough next Wednesday so that she is able to go to school (even if only for cupcakes) and celebrate with the awesome jungle cupcakes we have planned for the class. Not only has she planned for the 21 students in her class, but also plans on another 20 "extras" for teachers, etc. I think she is giving one to every aide, teacher, etc. she knows, which is fine with me! The cupcake distribution is a big highlight for every second grader and she is carefully planning it.

Thanks for all of your comments on the blog, we read them tonight together and she tries to guess who they are from as I'm reading them. She really gets a kick out of them. Thank you also for all of the unique and wonderful bandaids she has received. Today she picked "bacon" for her finger stick, and she has all the nurses guessing what it is. It's a perfect distraction for her. The childlife specialist says that next they are going to make a bandaid collage and frame it, but I don't think Hannah will agree to give up any of her special bandaids for that.

xoxo
Kim