Day 70 - Round 3 plans revealed

     Cristy and Evan went to CHoA today to complete his second round of chemotherapy and to learn the specifics for the next phase.  The main concerns we have at the moment is the nausea and vomiting that Evan is experiencing daily, leading to significant weight loss and his lack of mobility.  PT is scheduled for Saturday morning, however in the meantime we've been told we can remove his walking boot and maintain the exercises we've been performing over the last week.

Waiting to get called back to the OR.

     The day started with Evan's final LP (spinal tap) for this round, followed by an infusion of IVIG to help boost his immune system.  We received the blood counts as of this morning and they looked really good.  Platelets, WBC and ANC were all healthy, while his hemoglobin numbers were at a very comfortable level.  I feel confident that once he starts eating a more balanced diet again the hemoglobin counts will return to a normal level.
     The next round of chemotherapy will begin next Tuesday and run over two months.  During this time he'll have five sessions, each consisting of IV based methotrexate and vincristine.  The drips will both be short in duration and we're told it will affect his blood counts, but shouldn't bottom him out.  Cristy and I will keep a close eye on the counts each session and try to monitor and adjust his physical activities and social interactions accordingly.

Evan heading to surgery with a service dog escort.

     Evan's doctor gave us the approval to drop the flagyl and he only has one more night of 6-MP.  These seem to be the two drugs that cause the most problems with his stomach.  The doctor's advice was to focus on walking again and to pump calories into him any way we can.  There's no smoking gun for the nausea and stomach pain.  The staff feels that Evan was sick for so long that his digestive track likely has to sort things back out and the doctor felt confident this would happen given more time.
     In addition to dropping the two nausea provoking drugs we will also be able to start weaning off some of the others, such as the ativan and potentially the zofran.  Personally I'm not convinced the bentyl is doing anything one way or another, but we'll continue administering it for now.
     Evan seemed relatively at ease with his appointment today.  I suppose the fact that he and Cristy left around 6:00 this morning didn't hurt.  The nurses at CHoA made a nice card for him and the family experience team brought him some gifts to help celebrate his birthday.  I know some of the nurses follow the blog and I want to say thank you so much!

Catching a quick nap.

     I also want to say thank you to our next door neighbors and Evan's teacher for stopping by to check on him and wish him well.  The teachers and students in Evan's kindergarten class made him a laminated birthday book with happy birthday wishes and pictures of themselves.  When the day comes that Evan is able to attend school in person he should be able to put some of the names with the faces.  In the meantime we'll continue to heal up and create as many great memories as we can.

Fighting with a smile on his face.