Clinic 11-7-11 Phase 2 of Chemo Begins

Monday took us back to the clinic to begin the second phase of Jacob’s treatments. This one will last about four weeks (28 days, I think). This phase—called Consolidation—is generally a little easier than some of the others, meaning Jacob will be feeling a little better. So far that has been the case. I posted on Sunday about him playing with his brother and his toys and that has happened everyday this week. Yay!

The Consolidation phase mostly focuses on getting the cancer-killing medicine into the blood that is in Jacob’s brain. Our bodies have a blood-brain barrier that prevents things—medicine, disease—from getting into our brains and that’s a good thing; it’s designed very well and I’m grateful for this “barrier.” But, to be sure that the chemo can kill any leukemia cells that might be hiding in Jacob’s brain we have to get around this barrier (as I understand it). Regular chemo injected into his veins won’t get to the brain. So, the medicine, called methotrexate, is injected into his spinal fluid in a procedure called a lumbar puncture. We also have a chemo medicine that we give to Jacob each day at home.

Sad face, I know. Pretty sure he is glaring right at the nurse or doctor at this moment and the face accurately sums up his feelings. If you look closely you can see his port accessed there on his chest. Each time we go to clinic they poke through his skin to ‘access his port.’ Then there is a tube that hangs down and they can draw blood, inject medicine or do whatever they need to do. When it’s time to go home they take out the needle and ‘de-access’ him. The hardest part of the de-access is pulling that sticker off. And at access time the anticipation is worse than the actual “poke” I think. Plus we have a numbing cream we put on it before we go so it’s not so bad.

After all of the tummy trouble Jacob’s been having lately the doctors were extra concerned and wanted to follow up on how he is doing stomach-and-gut-wise. Here Dr. Sato is checking his belly, seeing how tight it is, how big it is, etc. Can you guess what he’s playing on my phone? Starts with “angry” and ends with “birds.”

Clinic isn’t all miserable though, he gets to play with this cool dinosaur robot while we’re waiting for his lumbar puncture procedure. And in the other picture we’re laughing at the dinosaur robot running into the garbage can.

So lumbar punctures for the next two weeks (on 14th and the 21st) and that’s it for this phase. And the medicine at home until the end of the month and then Consolidation will be done. I’m just glad there’s no more steroids (for now). Jacob is sleeping through the night and feeling much less cranky (I mean, other than that picture above…but, you know, who wouldn’t be?)

Clinic stats:

Height: 40.5” (102.8 cm) hasn’t changed much

Weight: 39.8 lbs. (18.1 k) hasn’t changed much

And I don’t know his ANC, hematocrits or platelets—it just didn’t come up. I assume since he hadn’t had chemo for nine days (since Oct. 28th) that these numbers were all high and we didn’t need to talk about them. But I do have some new important numbers to report: his tummy measures 61.5 cm (about what it was when we left the hospital) and we hope that goes down as he continues to get cleaned out. And his bilirubin is down…but I can’t remember the number. It’s down and that’s good! Means his liver’s doing good.