Interm Maintenance II is finished! Joel was supposed to have five increasing doses of methotrexate every 10 days but his counts dropped and never really recovered so he ended up just having it increased once and the rest of the doses stayed the same. He was quite sick thru most of the treatment, he stopped eating for awhile and lost a bit of weight. He also lost his sense of taste and smell but that has just started coming back. He was delayed twice during the last set of treatment. His last two weeks at home were great though and he said that he was feeling better than he has felt in the past year.
Blood counts yesterday were all good, actually they were on the low side of NORMAL!
Hemoglobin - 116
Platelets - 318
White cells - 3.1
ANC - 1.69
Joel started Delayed Intensification II today at 10:00 am. He began the day with spinal methotrexate, then he got vincristine and doxorubicin thru his port, and he started on the steroid dexamethasone. Joel doesn't like the feeling of the medication or of being put to sleep so he choses to have the spinals done while awake and alert. In a couple of days he will get another dose of PEG-Asparaginase and then he can come home again. He will hopefully be home for about 25 days and he will be having his chemo done in Vernon during that time. Delayed Intensification II is pretty much just like the first Delayed Intensification except that during the second half he will also have radiation and he won't get the other steroid (thioguanine).
The dexamethasone makes Joel feel very irritable so we all have to be careful not to annoy him over the next few weeks. He is on it for one week and then he gets a week off before starting it again. The book says that doing it this way (discontinuous dexamethasone) is not considered "experimental" since it has been used in many past studies; it is being given in this way for subject safety reasons. I am not reassured when I read things like that, it tends to have the opposite effect on me. Coming off it is very painful as the dex seems to attack the bones, joints and any previous injury sites but I am prepared with a freezer full of ice packs, bags of frozen peas and calcium supplements.
And Joel will lose his hair again, just when it was growing in so nicely, but this should be the last time.
Just 57 more days until Maintenance.