Wednesday, December 17, 2008

Traveling To Houston, New Chemo And The Holidays

Marissa and I have been very busy since our last post. I finished my 8th and final round of Ifosfamide and Adriamycin, and I was not sad to see that regimen over with. After my usual “bad” week after chemo, I was feeling well enough to travel. Marissa and I left to go to Knoxville, TN to spend Thanksgiving with Marissa’s mom and grandmother the Monday before Thanksgiving. We were able to spend a week there before having to leave again for Houston. We had a great time and really enjoyed getting away. It had been almost a year since our last visit to Knoxville, and we had a lot of fun doing some of the things we always enjoyed when we lived there. It also gave us a chance to visit with some friends we hadn’t seen in awhile. Our dogs went with us, and they stayed in Knoxville while we went on to Houston the following Monday.

We arrived in Houston on Tuesday, December 2. This visit we actually had someone to greet us when we arrived. Marissa’s mom’s husband, Gary, is in Houston working for FEMA. He gave us his hotel room for several nights, it was only about a block away from MD Anderson, and we all went out to dinner a couple of times during our stay. This made our stay in Houston go by much quicker, and we enjoyed being able to visit with Gary.

Wednesday, December 3 my lab work and scans were performed. Thursday, December 4 we met with Dr. Trent. Dr. Trent told us that the chemotherapy was still working well and shrinking my masses. Of course Marissa and I were happy and very grateful for this news. We then decided to stay in Houston for my 9th round of chemo, as it was a new regimen and required me to be inpatient for 5 days. We decided we were more comfortable receiving this treatment at MD Anderson. I was scheduled to be admitted right after my appointment with Dr. Trent. However, we were sent back to the hotel as no rooms were available. So, Gary gave up his hotel room for another night, and Friday, December 5 I would be admitted.

Friday, December 5 I finally received a phone call from MD Anderson at 5 p.m. telling me my room would be ready around 6:30 p.m. So Friday evening Marissa and I settled in, and I prepared to start my 9th round of chemotherapy. This regimen consists of high dose Ifosfamide only. It is given inpatient because of all of the fluids that must accompany it, as well as monitoring my kidneys daily. There are many pre-medications to receive before the Ifosfamide. The Ifosfamide runs every 12 hours for 2 hours for a total of 7 courses. My first course of Ifosfamide began at 2 a.m. Over the next couple of days I experienced some nausea, but discovered I preferred to be inpatient. Before with my outpatient chemotherapy I had to bring home back packs with infusion pumps that gave me continuous chemo and fluids, and I did not enjoy lugging those heavy packs around. Tuesday, December 9 I received my last dose of Ifosfamide at 2 a.m. All of my lab work was coming back great so I was on track to be released Wednesday, December 10.

Wednesday, December 10 I was told I could be discharged, but there was a catch. I had been receiving over 6 liters of fluids a day and to be released I would have to be able to drink over 2 liters on my own. I was having a hard time drinking as I was feeling nauseous, so Marissa and I discussed it and we decided the best thing to do was to stay in the hospital 1 more day. We were concerned about such a long trip home and we wanted to play it safe. The rest of Wednesday I received fluids, and the next day I would be released. All in all my inpatient experience was very pleasant, and the nurses were really great.

Thursday, December 11 I was released as promised at about noon. Marissa had the car all packed, and we left for home straight from the hospital. We decided to make the drive all in one day so I would be back at home in case I needed fluids. We arrived at home in GA at about 4 a.m. Friday morning. Driving straight through made one really long ride for me and one really long drive for Marissa. Needless to say, we were very glad to be home. Friday, December 12 we were relaxing at home with our dogs, who were delivered that afternoon.

Saturday, December 12 I had a sudden fever. Later that evening it was only getting higher so Marissa and I headed for the ER at Emory Crawford Long. They took several blood cultures to send off, took some lab work, a chest x-ray and gave me fluids. When my lab results came back we learned that my white blood cells were only at 0.2. On Thursday before we left Houston they were at 16. We did not anticipate them falling so quickly, but then again with this new chemo we did not really know what to expect. My fever was due to my low white blood cell count (neutropenic fever), just as I had experienced my first round of chemo. The doctor on call wanted to admit me and give me IV antibiotics until my blood cultures came back. This would take between 24-72 hours. As I am already on preventative antibiotics I decided with my low white blood cell count I would probably be better off at home. From Saturday until Tuesday, December 16 I had a high fever and had to take Tylenol almost around the clock. My blood cultures did come back during this time and were negative for infection.

That brings us up to today, Wednesday, December 17. My fever is gone, but my lab work today showed that my hemoglobin is low (7.5). While all of my other counts (white blood cells, platelets) have started to come back up my hemoglobin is falling. Tomorrow, Thursday, December 18 I will go in for an outpatient blood transfusion. This will be my second transfusion. The first time they did not catch my low hemoglobin until it was 6.6, this made me have to receive the transfusion inpatient as it was necessary to get it that same day. That time I received 3 units of packed red blood cells, tomorrow I will receive 2. This should be enough to boost my hemoglobin to above 9 and prevent me from needing blood over the holidays (hopefully). Despite the fever and blood transfusion I have not felt as bad after the chemo with this new regimen. Hopefully this continues to be the case, and that the next round I will not have the fever and low hemoglobin to deal with.

As far as Christmas celebrations go, Marissa’s family got together this past Sunday while her mom and grandmother were in town. With my fever I was not able to go, but Marissa did bring me home a plate of dinner which I did get to enjoy. My family is planning on coming to Georgia to visit and celebrate Christmas the Saturday after Christmas. I am very excited about this as my siblings have not ever even seen our home in Georgia. We have decided again to travel to Houston for my next round of chemo, we are more comfortable with my care and treatment there. We will be leaving on December 31 with my chemo being scheduled inpatient to begin on Friday, January 2.

Marissa and I wish you all a very Merry Christmas filled with family and loved ones and a safe, happy, healthy New Year.