On Thursday, November 11, 2010, Carl started a course of chemotherapy that featured the drugs Irinotecan and Vinchristine. The 'protocol' for this chemotherapy is a dose on Day 1 and Day 8. On Day 21, the patient can start the course again. The Day 1 and Day 8 doses are delivered through IVs into his port. He gets these doses at the outpatient Froedtert Cancer Center Day Hospital.
Under this protocol, Day 8 is tomorrow, Thursday, November 18, 2010. So tomorrow we will once again trek down to the Cancer Center. Carl will be connected to the IV for around 3 hours, making this one of the shorter chemotherapy sessions, although with the registration and waiting, we will end up being at the Cancer center more then 1/2 of the day.
Carl 'completed' one course of chemotherapy with the drug Irinotecan before, getting the drugs on Monday, October 18, 2010 and Monday, October 25, 2010. He tolerated the Irinotecan well, so the Doctor added the Vincristine to this course.
I hope these drugs are effective and that Carl can continue getting them for quite some time. At the end of the month the Doctors will check to see if the drugs are holding back the tumor.
Thank you again for all the encouragement and prayers.
So, isn't this kind of a boring post? I hope the photos from one of our trips to the pumpkin farm make it more cheery.
This last photo shows one of the side effects of the Adriomycin chemotherapy. (photo taken October 17, 2010.) Carl didn't loose all of his eyebrow or eyelash hair like some people do, but wow, did it thin out. Already his hair (and eyebrows, and eye lashes) are growing back in. Another reason I hope that Carl can use these drugs for quite some time.
Carl completed his 4th round of chemotherapy (third round of inpatient Chemotherapy) on Friday, March 5, 2010. He was in the Froedtert Hospital continuously from Monday, March 1, 2010 through Friday.
Carl and I think he is tolerating the chemotherapy very well, although Carl said Thursday and Friday were really bad. I tried to get him to define it, and he said that Thursday alone felt like 40 hours of having the flu. The bed is always moving and he thinks he was awake almost every 2 hours.
Here is a photo of Carl on Thursday. On Thursday, he can hardly open his eyes. It was a hugely busy week for the children and me, and only Miranda got a chance to visit Carl in the Hospital, and only on Thursday. (Visiting earlier in the week is preferred.) The other three children wanted to stay home. I'm not sure what to think about that, but Miranda and I had a nice visit.
The photo below shows what Carl and Miranda think of chemotherapy. But we don't hate the chemo, oh no. Hate the cancer, love the treatments. Or at least tolerate them. Technology and prayers will keep Carl alive.
So this is what the inpatient rounds of chemotherapy infusions are like (approximately- don't go using this as a recipe for in-home care) for treating Carl's sarcoma (Mon-Friday Jan 18-22, 2010; Mon-Friday Feb 8-12, 2010; Mon-Friday March 1-5, 2010).
Chemotherapy for Round 2, 3, and 4:
- Over 2 hours of time, Simultaneously
- Saline solution, 1400 mg.
- Ondansetron 16 mg - Anti Nausea medication
- Dexamethasone 20 mg - Anti Nausea medication
- Over the next 22 hours of time
- Mesna 700 mg - this protects the kidneys linings from bleeding, which is a side effect from taking Ifosfamide.
- Ifosfamide, 3800 mg in 500 ml of saline solution.
- Adriomycin, 34 mg in 500 ml of saline solution. This is the heavy hitting drug, and the main difference from the outpatient chemotherapy.
- When those bags are empty, a saline flush of the IV ports, followed by heparin, and then Carl is disconnected so that he can take a shower. Once the shower is over, he is connected up again, and the next 22 hours infusion starts. This is done 4 times in all.
- After 4 days, Over the last 6 hours of time
- Saline solution, 1400 mg.
- Mesna 1400 mg - Mesna protects the kidneys linings from bleeding, which is a side effect from taking Ifosfamide.
- When those last bags are empty, a saline flush of the IV ports, followed by heparin, and then Carl is disconnected. And he can go home. Yeah. Tired.
Most days in the hospital, Carl took about seven oral drugs a day as well. More fun.
24 hours after the end of the in-patient chemotherapy, on either Saturday or Sunday, Carl has to go back to the Medical complex, this time the Cancer Center's 3rd floor Day hospital, for the Neulasta shot.
This is a picture of the Neulasta (also known as pegfilgrastin) injection. The instructions say "do not shake tube". So now I wonder, what happens if you shake the tube? Will it blow up? Or just not work? Whatever. Don't shake it. We want it to do whatever it is that it does.
(Dr. Seuss could say it better.)
[Neulasta promotes the white blood cell count, since the chemotherapy just wiped out all the white blood cells as a side effect, and white blood cells are kind of nice to have around.]
And finally, here is Carl walking out of the 3rd floor Cancer Center Day Hospital. Maybe someday I will tell you a funny story about this picture.
The Cancer Center is a beautiful facility that just opened in May 15, 2008. (I think the Cancer Center is officially called The Froedtert and Medical College of Wisconsin Clinical Cancer Center, [that's 10 words...] I've also seen it referred to as the MCW Clinical Cancer Center - much more catchy.) The titles leave me wondering: just what does the work "Clinical" add to the name, besides three syllables, I mean. A warm and fuzzy feeling? Whatever. Beautiful building, $95 million dollars of technology, and Carl can't wait to leave.
P.S. The MCW acronym is frequently referred to as M-COW. Very Wisconsin like, don't you think?
