I took Joel in for blood work this morning and it looks like his counts are still too low for starting treatment tomorrow so he gets to stay home for a few more days. His ANC was at .4 and it needs to be at least .75, but all his other counts were fine. We will go for blood work again on Thursday to see if he can start chemo again on Friday. I am glad that we get to keep him home for a little longer because he is just starting to eat normally again (three meals a day) and he hasn't thrown up since Saturday night so maybe I can get a little weight back on him. This week I made him spaghetti dinner, beef stroganoff, burgers, salmon, peach upside down cake and lots of apple pie. He is not needing the morphine anymore and he only uses the anti-nausea medication once in a while.
I am learning how to give Joel his needles because he does not like to do it himself. Joel is taking advantage of me though and giving me puppy eyes and asking for his hearts desire whenever I come close with the needle. I will have to become a hard, cold and unfeeling mother or else I am afraid that I will lose my good judgement, end up poor and without any scruples. I think I am doing something right though because he says that when I give him the needles it hurts less than when Grant gives them…… I have a few tricks up my sleeve. I find that I hold my breath while I give him the shot so I have to do it quickly before I pass out. My devious plan is to have Joel prefer me giving the needles so that I can go down to Vancouver with him all the time.
We had a quick chat with Joel's clinic nurse this morning and she said that Joel would not be getting the Peg-Aspariginase and the spinal chemo this time around. He will just get the Vincristine and Methotrexate thru the port. I guess the thinking is that if his brain is irritated and enflamed, then the chemo going into the spinal fluid and brain would just make the problem worse (like putting vinegar or lemon juice on an open wound). He will have to make up those treatments at some point but I guess we will learn more next time we see Dr. Dix. There is some concern that Joel's treatment is being delayed too long but hopefully his counts will come back up quickly. Exercise is supposed to bring the ANC counts up so I will have him doing laps everyday.
I have been learning lots about clots and strokes this past week. Joel's clot is in the Sinus Venous Thrombosis, the vein running along the top center part of the brain. Blood tends to run through that vein slower and that is why that area is more susceptible to clots. The headache was caused by irritation and pressure from the clot and blood flow. The assumption is that the second stroke (or stroke symptoms) was maybe caused by small bits of the clot breaking off. Hopefully the blood thinner (enoxaparin) will have caused the clot to become inactive and stable by now. Strokes can be caused by bleeding in the brain but the CAT-scan showed that Joel did not have any. Strokes are also much more destructive and cause permanent brain damage if they happen in an artery where they cut off oxygen to the brain, rather than if they happen in a vein. When Joel had the first stroke on August 2nd, he was scared. That was the first time during all of this that I saw fear in his face. He has been miserable but he does not complain. When Brianna was on her way to visit Joel in the hospital she sent me the following text - "Okay we are getting close. I'll text you as soon as we are parked. How is Joel? Does he look like himself?" That broke my heart. Joel had her comfortable, relieved and laughing in no time. The second time that his body went numb on the left side, he was chatting with the oncologist on the phone, laughing and making jokes.
This week Joel said the old men have nothing on him…. he has had arthritis, strokes, pain, weakness, baldness… just to name a few. Sometimes he has to drink Boost and sometimes when he walks, he even looks like an old man. I love you Joel!