Thursday, September 12, 2013

Week 7

Nothing too exciting to report.  Back on Carboplatin and Vincristine for 4 more weeks till Logan's next MRI.  Logan did fairly well today, aside from the fact that he was REALLY cranky.  He has not been sleeping well so everything seems to be a major drama production.  Blood results were off here and there.  Some levels were low (WBC, RBC, Hemoglobin, etc.) and some were high (bilirubin, MCH, MCHC, etc)  What that all really means, I have no idea.  I know they are monitoring his blood counts and liver function and the basics behind that.  They were comfortable moving forward with treatment, so I'm not too concerned.  Orders from the doctors, continue with stretches for his heel cord tightening and start giving some stronger intervention for the constipation.  Miralax here we come.

Today's waiting room treat, professional photography from the Flashes of Hope organization.  Another great charity organization devoted to making these kids lives just a little brighter.  Professional photographers come out to children's hospitals all over the country to take pictures of children and their families to "capture those smiles and forever preserve images of courage, beauty and dignity."  You can read more about this organization here.  Logan was a ham, as usual, so I'm excited to see what pictures they were able to take.

Now that we are at 7 weeks, we have gotten the routine down. Like I've said before.  Routines are our friends. For those that are curious what goes on at these "routine" appointments here is a walk-through of our typical chemo day at the hospital (Times are approximate according to the most time efficient sessions):

8:00 - Arrive at hospital, apply numbing cream and have breakfast in the cafeteria.  
8:30 - Arrive at clinic and check in.  Preliminary screening to sign off that Logan has not showed signs of fever, cough, runny nose, chicken pox, rashes, vaccinations in the previous days.
9:00 - Called back by intake nurse for Vital checks (Blood pressure, oxygen stats, temperature, height, weight, head circumference.)
9:20 - Lab for port access and blood draws.  Blood sent for counts.
9:30 - Meet with Doctors for neuro exams.  Each one of the three doctors (sometimes 4 or 5 depending on who has colleagues in the lab that day)  perform an assessment consisting of testing strength in the extremities, coordination, visual tracking, peripheral vision, etc.  We discuss any concerns from the previous week and plans moving forward.
10:15 - To the art therapy room to play and wait for the blood counts and chemo to be ready.
10:45 - Doctors pop in art room to let us know the counts and that the chemo has been ordered.  They have to wait for the count approval before even ordering the chemo from the pharmacy as it is fairly common for a child to have to an issue and not be allowed treatment for the week.  That would be a really expensive waste.
11:00- To the pod to start prepping and infusing.  Line is prepped and flushed.  Anti-nausea medication is given so they can give it time to kick in.
11:30- Vincristine pushed and Carboplatin infusion started.
12:45 - Final flushes, port de-access and time to go home for lunch and a nice long nap!

Efficiency and order varies from session to session, but generally we spend 4-7 hours there (yeah - 7 hours - that day sucked) and are seen by around 7-10 different nurses and doctors. 

Much needed infusion nap!

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