The waiting game

My apologies for the delayed update - There is a lot to catch you up on...

Yesterday, a week ago William was discharged from the hospital. The 5  days of chemotherapy went better than anticipated and his bladder had minimal bleeding (all things considered).  On Monday,William started his daily injections of Neupogen. Thanks to a lot of bribes, numbing cream and grandma's hugs, we have been successful in doing the injections with very little tears.

Besides the usual bi-weekly clinic visit and blood test, our week also consisted of a conference with the BMT (Bone Marrow Transplant) team, and a last minute double bone marrow aspiration.

On Thursday morning the three of us (me, grandma, and William) met with Dr. Wolfson and her Nurse Practitioner. SIDE NOTE -- William has met several female doctors here and he was completed surprised by the fact that girls could be doctors too.  Dr. Wolfson is the transplant doctor, and she will be taking charge of William's treatment until after the blood marrow transplant has been completed. Dr. Anderson will continue to be our Oncologist, but all orders and procedures go through Dr. Wolfson and her team.

Topics and discussion notes from the meeting with Dr. Wolfson and her NP.

1~What to expect. Side effects of the stem cell harvesting and the transplant.
-Infections -
-Veno-occlusive Disease (VOD) of the liver
-Interstitial Pneumonia Syndrome (IPS)
-Graft Failure
-Cataracts
-Mucositis
Please read click here to read article about all the above mentioned side effects.

2~How the process works.
William will be admitted for approx. 5 days during which a new double line catheter will be inserted into the groin area. Using a process and machine called Aspheresis, blood and stem cells will be collected over a 5 hour period each day for approx. 3 to 5 days.  

Once William has completed two round of High Dose Chemo, the transplant will be done via IV. We were told to anticipate isolation for approx 30 days. Also, for approximately 100 days after transplant, William will be on a bacteria free diet and germ free living environment.

3~Chemotherapy
The high dose chemotherapy that will be used is a "recipe" specific to the City of Hope. Busulfan, Melphalan, and Topotecan are all very successful chemos and because William has never received them or any similar, there will be no resistance from the tumors ;) The side effects of the chemo will be nothing new but, the management and prevention of them will done by the BMT team on a daily basis ( basically this means that William will get a lot of drugs, antibiotics, pain meds, nausea meds and  bladder/bowl management care)

4~Transplant Prep

Due to the fact that the high dose chemo and transplant can both cause serious problems, William's vital stats will be monitored closely for any abnormalities. To figure out and calculate what is "normal" for William he will be going through several pre-transplant tests.They are as follow:
-Chest X-Ray ( Check- this was done yesterday)
-EKG
-Echo cardiogram
-CT Scan
-Multi Gated Acquisition Scan
-Pulmonary Function Tests

-Bone Marrow Aspiration (Check - This was done on Friday)
-Dental Exam
-MRI

-Gallium Scan

I think that covers most of the information - I have an overflow of information going on in my head, so I apologize if I left something out.

Randell was able to visit us this weekend! We missed him so much, and being able to spend a few days with him was extremely therapeutic for both William and I.   Hopefully, if all goes well, William and I will be able to return home (to Nor. Cal) for Memorial Day Weekend.

Sometime during the weekend William accidentally bit his lip - long story short, the bite got infected (no white blood cells to fight germs) and now, we are back at City of Hope. I was extremely concerned that the infection and several antibiotics would somehow postpone the Stem Cell Rescue/Harvest/Collection process however, Dr. Anderson assured me this morning that he will push to get the procedure completed on schedule. (Yippee)

Well, that is enough writing for the day - I will try to update again tomorrow.

Keep on Keeping on! Live Strong in God's promise of permanently healing the cancer in William's body.