Round 2 at MDACC for Chemo Part B

Monday we reported to MDACC for Joe to get his lab work done and see Dr. Romaguera before Joe got readmitted into the hospital for Part B of HyperCVD-R. Joe had some anxiety with the long wait in finding out his white blood counts which could have delayed the next chemo round. Dr Romaguera stated that he would proceed with Part B and slowly add the monoclonal antibody, Rituzimab on the last day but he wanted to see the WBC. He called the Lab to see if they could give him the preliminary WBC. Dr R went ahead and wrote up the three page of instructions for the next round of chemo. Talk about detail. It is major detail. I always request a copy of the hospital orders so I can be sure that Joe is being given the right stuff at the right time. Dr R requested that we wait out in the Lymphoma waiting room until he found out what the WBC was. What joy we shared when  Dr R came out to tell us that the WBC had dropped to 56. Whew..... some good news!!!! His nurse hand delivered the hospital orders and we walked down to Admissions on the 1st floor to hand them off. We went off to get a bite to eat at the Cafeteria down the hall since we both were starving since it was almost 5PM  and a log time the stop at Panera Bread in the morning.

When we went back to the Admissions desk, we had to wait only a few moments before Joe was assigned a room at P931. We climbed into Elevator E and the room has just been expertly cleaned and set up by the staff. Everyone introduced themselves as to what they do etc and wrote their name on the board. I went back to the car way on the other side of MDACC and got Joe's bag. Joe was comfortable and I unpacked all his stuff and got him settled. The nurse advised none of Joe's IV's and drugs were there yet and that it may be very late when they got his supplies. It was OK with us. We watched the final World Series game and I headed back to the studio apartment to take care of Max, relax and spend the night away from the hospital.

Tuesday I stopped by Panera Bread and had my daily bagel and got Joe his favorite Panera pastry called Cobblestone. He craves it along with his coffee. Since I did not get to the parking garage #2 till 11AM, It took me 20 minutes to find a parking spot and I creatively got one by ignoring the down yellow " do not enter" tape. Joe had already called me twice as to where I was. I stopped at the foyer coffee shop and got Joe his needed coffee fix and I headed up to the 9th floor.

Joe had been set up with his IV's and just started his 24 hours of the first chemo "M". Joe ordered his lunch of cheese enchiladas with refried beans which he said was delicious. I did scrap off the green scallions that were on top of the enchiladas. Joe continued to feel great as staff kept coming in and out. The Lymphoma"on call" doc told that us Joe needed two pints of blood since his red blood count was low with the hemoglobin being a very low 7.3 which is the lowest that it ever has been. I am sure the chemo from the first round was making its presence know.

About 1:30PM I called Emory Clinic in Atlanta to cancel Joe's 11/18 neurologist appointment which I had made for Joe to get a second opinion on his night time seizure syndrome. Not more than 30 minutes later, a MDACC Neurologist doctor popped in and stated that he heard that we wanted a second opinion of Joe's seizure medication. What!?! We had not asked for that but we sure wanted a second opinion. Divine intervention turns up in another chapter in this journey. He said that Dilantin metabolizes through the liver and could interact with the chemotherapy drugs. There are new drugs that would fit Joe's seizure syndrome better than metabolize through the kidneys instead. It sound logical to us.

About an hour passed when two different doctors from Neurology-Oncology department came in to see Joe. They discussed the same information and said they recommend using Keppra. The hair on the back of my neck started to rise up sensing there must be more to all of this since we now saw three neurologists in one hour of so.

Joe has been taking Dilantin for over 20 years and about twice a year he would have a break through seizure after a few minutes of falling asleep. He has had the same neurologist in Atlanta nearly all those years and  he has kept Joe on Dilantin and never gave us any cause to be concerned. I decided to do some digging and I found out the following on drugs.co

"Hemopoietic complications, some fatal, have occasionally been reported in association with administration of phenytoin. These have included thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, and pancytopenia with or without bone marrow suppression. While macrocytosis and megaloblastic anemia have occurred, these conditions usually respond to folic acid therapy. Lymphadenopathy including benign lymph node hyperplasia, pseudolymphoma, lymphoma, and Hodgkin's disease have been reported."

Good grief.....it is possible that all the years on Dilantin

After they left Whitney Wilkerson called from Victoria, TX and that she was going to be in the Houston area on Wednesday and wanted to stop by in the afternoon. While Whitney was a seminary student at Columbia Seminary, she worked at Eastminster Presbyterian where she was much loved. She is also a gifted speaker and a warm lovely young lady. It will be a brighter day with Whitney's visit on Wednesday afternoon.

Since Joe is active getting chemo and more blood all night, I decided to spend the night with him in the hospital. I have been guided to be there and I go by the message from the Holy Spirit which I have learned to trust. I came back to the studio apartment to spend some  time with Max and let him out of his kennel since the maid finished cleaning our room which she does once a week. I watched GLEE and took Max for a walk several times.

We were blessed with some other gifts such as our dear neighbors, the Bennetts, had sent our mail in a big box to us. Greg has been blowing off our driveway and moving Joe's truck in the driveway.
I also got a call last night from some other great neighbors, the Lesters who live across the street from us. Charlie has been diligently watering our newly planted lawn and that it looked great! Nancy told me that they were going to have their lawn service mow our lawn this weekend. Wow! Do we have great neighbors or what!

We continue to get Get Well cards from across the country and so many from members of our church. What a loving and caring congregation we belong to! God has directed our lives that we are only realizing how all the pieces are fitting together. Thanks be to God, for sure!

Joe just called and said the hospital is changing his room to over to the Lymphoma Floor, G961. I told him to go ahead to get them to move him. The Lymphoma floor specializes with Lymphoma patients. The extra good news for me is that I will have a real bed to sleep on which is a Murphy bed that pulls out of the wall. I will be able to sleep and another blessing comes our way.

Thank you all for you sincere kind thoughts and the prayers from Joe's Prayer Army where the prayers are being answered in so many different ways.

Many blessings to you and your loved ones.
CIAO!
Bonnie