Day 6; Because I Like Checklists And Spreadsheets

Not much to update because today is Sunday and the unit is very quiet.  The attending doctor came by and I let Abigail have a private discussion with her.  Whenever a medical provider asks her if she has any questions she looks at me and says, "Do I?"  So I said to her today that they want to know if SHE has any questions and that I would give her privacy to talk to her doctor alone.

I also "encouraged" (read: made) her take a shower unassisted last night, undress and redress herself, brush her teeth, and now that she is off IV fluids, she is taking herself to the bathroom.  This all seems like pretty reasonable stuff, right, but she was so weak from almost a full week of essentially being bed-bound, that yesterday, even a walk down to the cafeteria, was so taxing we had to take a wheelchair back to the unit.  Today we put a special mask on her, and we walked outside even.  I am proud of her.  Her nurse is being very pushy (as she should be) about her getting out of bed, walking, and drinking enough liquids.  If she does not drink 2.5 L today she might have to go home on fluids.  I cannot tell you now much I do NOT want this for her.  So I made a chart - LOL - some of my friends understand my obsession with spreadsheets and charts - for her to see her fluid progress.  Some people overeat or drink too much when they are stressed out, but I make spreadsheets.

Here is the schedule for induction (the first phase) and the names of the drugs she is to receive.  

Oh and the study is AALL1131.

Day -1: Intrathecal Cytarabine (IT ARAC).  She got this Monday at the time of her first lumbar puncture (LP).  It is chemo they put in her spinal fluid.  That is was intrathecal means. 

Day 1: Vincristine (VCR), Daunorubicin (DAUN), Prednisone (start of a 28 day course, oral)

Day 4: Pegaspargase (PEG-ASP)

Day 8: IT Methotrexate, VCR, DAUN (she will have this tomorrow, on day 7, to facilitate easier discharge)

Day 15: VCR, DAUN

Day 22: VCR, DAUN

Day 29: IT Methotrexate; also bone marrow studies.  Risk stratification and treatment randomization occur here as well.

On Day 36 when her blood count parameters are met, and after treatment randomization is complete (if we chose to stay "on study") she will being the next course of treatment called Consolidation.

Common Side Effects:

Vincristine has side effects of: constipation, hair loss, jaw pain, and weakness.

Daunorubicin has side effects of hair loss, vomiting, and pink or red colored urine, tears, sweat.

Prednisone has major side effects of mood swings, acne, increased appetite, weight gain, stomach pain, and loss of bone density. 

Pegasparagase has a side effect of allergic reaction

Methotrexate IT has side effects of GI upset, vomiting, nausea, headache.

And enough of that medical jargon....

Here are some pics of this lovely establishment I now feel like is my second home.  Yes, already.