5/21/11 LAST ROUND!

On 5/20 Joe started the day with visits to Infectious Disease to determine whether his infections were under control so he could do his last round of HyperCVAD-R. We both sat on the edge of our chairs with nervous anticipation. They cleared him! It was such a huge relief since Joe was not in any mood for any more postponements.

The afternoon of 5/20 Joe had his blood tests followed by the very important visit with Dr. Romaguera. Joe was cleared to enter MDACC for his last round that very day. There were some very important items to work out with all the departments that has worked on Joe with his medications. The Pharm-D advised us that one of Joe's antibiotics interferes with the toxicity of methrotrexare. The pharmacist recommended some substitutions that had to approved by Infectious Disease, There were some other items that were to be discontinued because of the interference with methotrexate such as 81mg of aspirin, B12 complex and I forgot what else. It took from 2Pm to 7:30pm before Joe was finally admitted to the hospital. To our approval, Joe was placed on the awesome 15th floor of the new tower where the rooms are huge and very comfortable. Joe's first IV was Rituxan that started at 11PM and ended about 4Pm. He had no issues.

Today at 11AM they started the 24 hour infusion of Methotrexate which is so very strong where there can be serious issues with the kidneys so vital signs are watched very closely. Joe had some complaints of the intermittent diarrhea again so they got a sample of it to be tested. Today was the first time that Joe complained of some burning when he urinated. So I made an intense effort to have him drink more fluids. By the evening the burning urination had ceased but they took a urine sample anyway. His darn cough continues and is a little worse than it has been. All of these complaints make me so on edge since I am so conscious of the danger of infections. I suppose that I am more on edge since we are close to closing chapters of this stage of fighting the beasts. A dietitian came around at the behest of Romaguera because of Joe's weight loss, He is now down to 162 pounds from 169 three weeks ago. She gave Joe suggestions to add more calories and some fruit such as bananas and yogurt to control the intermittent diarrhea. I could tell that he was not seriously paying attention which drives me nuts.

Here is some of Joe's counts today since I know so many people are interested in following it.

White Blood Count 19.4 (high from the neupogin shots)
Red Blood Count 5.14 (normal)
Hemoglobin 14.5 (normal)
Hematocrit 45.4(normal)
Platelets 288 (normal)
ANC 16.49(high but a good thing)
ALC .78 (low, Rituxan working)
Electrolytes all in normal range

Romaguera, the PA and pharmacist all stated that Joe;s rebound of his blood counts have been quite remarkable for a 68 year old from the MCL and MF perspective. They stated that Joe has done better than other patients in their 40's and 50's. Joe is a good example why an oncologist should review the entire physical health of the patient and not look at their age with using HyperCVAD-R.

I was happy to see tonight on the future schedule that Joe has appointments for a massive amount of tests on 6/6, 6/7. 6/8 to re-stage his disease. He has a final late afternoon visit with the Lymphoma Oncologist to see if he is ready ti be discharged from the Lymphoma Department. The long journey is getting close to ending this trip.

Praying for success and a smoother ride.

Good night!