Today at clinic was not what we were hoping for, but not entirely unexpected. Hannah's ANC was only 547, and it has to be at least 750 to begin a new round of chemo. I was somewhat surprised that her doctor did not put her on the neupogen shots to boost her ANC until the next round. The reasoning was that she would only get a few days of shots in before they would have to be stopped 48 hours prior to chemo. Since they don't do routine admissions during the weekend, the earliest she could be admitted to start would be Monday, and we're already scheduled to start next Tuesday. He figures she is on the way back up now, and her body can come up on it's own by Tuesday, so why put her through the shots. They are not a guarantee anyway.
So, Hannah walked out today pretty happy. No accessing, no hospital and no shots! We really don't want her treatments delayed, becuse the chemo is precisely scheduled to be most effective. The longer you get away from that schedule, the less effective the chemo becomes. We are hoping for no more delays. The doctor did increase her appetite stimulant medicine because she has not been eating well over the past 2 weeks and that is going to get even worse as the chemo progresses in the next 3 rounds. She has lost weight the last two visits, and while it has not been a substantial amount, we don't want to see that trend continue.
For the rest of this week, no clinic visits and no treatments. She won't go to school tomorrow due to low counts. We were home schooling today after chemo anyway, and already have the homework for the week, so we'll play it by ear for the rest of the week. I would like her to go to school to keep with her routine, but also don't want to risk an infection prior to the next round. She is also quite tired, her hemoglobin is low, but not dangerously so, and she is sleeping quite a bit. She'll have the next several days to rest up.