Day 209 - Ice Ice Baby

     Another chemo treatment can be entered into the books.  Earlier today Evan visited the clinic and received the first of his next four Cytarabine injections in this round of chemotherapy.  We have a few more shots this week and oral pills, but these will end on Monday of next week.  From that point the medical team would like to wait until the end of the month before beginning Interim Maintenance, if his blood counts are high enough.  In the meantime Evan's counts will be checked weekly and monitored for any unusual drops or gains.

Getting a visit from Idina the service dog.

     Last week Evan gave Cristy and me a little scare because of an unexpected spot on his surgically repaired ankle.  Our Orthopedic surgeon had told us to keep a close eye on his foot following our last visit.  As fate would have it a red spot showed up on his ankle two days later.  The next day Cristy took Evan in for a once over from the doctors.  After a review and pictures they told us it could have been related to his body attacking bacteria in that region, but to continue watching it closely.  It's been about a week and I'm glad to say it looks exactly the same as when we first noticed it.

Little spots can be scary for neutropenic patients. 

     Yesterday Evan met with his primary ID doctor and with cardiology.  The main purpose of the ID visit was to draw a blood sample in order to confirm his Voriconazole levels were still at therapeutic levels.  This test takes a few days to return so we likely won't get an update on that until the end of this week.  Evan's cardiologist performed an EKG, but didn't see anything to cause alarm or any need to perform an ECHO at this time.  The reason for occasional cardiology exams is because of the strain these drugs can put on someone's heart.
     Our oncology doctor was able to share with us a bit more about Evan's future cancer schedule.  Interim Maintenance is slated to begin at the end of this month and each treatment will be spaced out by 10 days (depending on blood counts).  There are two spinal taps planned, along with various IV drugs and oral meds.  Tentatively the medical team would like to perform another surgical procedure to add a port back in to Evan's chest.  It was previously taken out due to the infections that Evan was fighting, but with these seemingly under control they're comfortable re-installing it.  This will eliminate the need for Cristy and me to clean the PICC twice daily and minimize the risk of infection.  Following Interim Maintenance Evan will move to Maintenance, which involves one visit monthly for IV based Vincristine and daily oral meds.
     Evan's appetite has stalled again, although his risk of significant weight loss is greatly reduced because of his feeding tube.  My hopes are that once we move into the Maintenance phase and off of these stronger drugs that his desire to eat will return.

Eating a little snow before bed.

     Last weekend the boys got to experience about 20 minutes of snow, as the rest of the 5 or 6 hours of precipitation was mainly ice.  Nevertheless they enjoyed it and the fact that they got to stay up a little later.  We've had unseasonably warm temps for the most part this winter, which I guess is good and bad.  I'm sure the boys would like to see Mother Nature give them one more attempt at snowy weather.

Watch out Nolan!