IC Day 50

It is nice to have some days that go as expected. We went into the Cancer Center this morning about 9am and had blood work taken right away. Nathan then received his Vinchristine through IV and then all we had to do was wait for the blood work to come back. We thought it would be OK just from the way Nathan was acting and we were right. His WBC was up at 2.71 with his Neutrophils being 2.29 of that so that is low for the white blood cells but in the normal range for Neutrophils (his Lymphocytes were low which is what makes up that difference.) His RBC was close to normal at 3.21 with his Hemoglobin at 91. Nathan's platelets were also in the normal range at 161. It seems like the transfusion of red blood cells that Nathan received last Wednesday really seemed to stimulate the rest of his blood production. As long as Nathan's counts do not dip drastically, which is possible with the chemotherapy, we will be on course to start the next phase next Monday.

That phase is called the Augmented Interim Maintenance, the Augmented part is for High Risk Leukemia patients like Nathan whereas Standard Risk patients just get Interim Maintenance. Additionally, instead of the standard four weeks, the Augmented is eight weeks long and to top that off, he actually goes through this phase a second time after the next phase. To get it straight again we started with the Induction Phase and that got Nathan into remission and further sub classed his Leukemia into High Risk. We then had Intensified Consolidation which we are just finishing and next it goes:
Augmented Interim Maintenance (8 weeks)
Augmented Delayed Intensification (8 weeks)
2nd Augmented Interim Maintenance (8 weeks)
2nd Augmented Delayed Intensification (8 weeks)
Maintenance (3 years)
Maintenance is our next goal, we need to get there sometime within the next 36 weeks without having a relapse - once again, a relapse starts us right back at square 1 but with everything bumped up another notch.

This phase is supposed to be easier on Nathan's body but I'm not too sure how that is as it appears like we will be much busier than even this past phase. For instance, Nathan has Vinchristine (IV), Methotrexate (IV), Intrathecal Methotrexate (lumbar puncture) and Erwinia Asparginase all on Day 1. He then has Erwinia Asparginase on Days 3, 5, 8, 10 & 12. Additionally he has the Vinchristine and Methotrexate on Days 11 & 21 and at Day 21 it starts all over again. So that means we are in the Cancer Center Monday, Wednesday, Friday, Monday, Wednesday, Thursday and Friday every two week segment.

Whew, that got kind of technical but if you think that is bad just wait until I let you know what the Augmented Delayed Intensification is about, it has a couple of chemo drugs that we haven't even seen yet to date and he hits the steroids again.

Anyway, we also talked to Dr Ali about Nathan's cough and low grade fever and after examination he thinks it is just viral. He also said that he thought Nathan was in surprisingly good shape which was very nice to hear. Nathan also got to play with his Cancer buddy Michael for awhile in the playroom. Even after we were cleared to go and de-accessed Nathan had to stay and play for another 15 minutes. And since it seems like the Cancer Center is our only social (and only) outing Shelley and I were willing to stay and visit with the other parents for a bit.

Nathan had a pretty good afternoon and as long as his counts appear to stay up and his cough doesn't get worse then we may actually be able to venture out a little bit this week.