Day 62 - Outstanding items

     Today has been almost a carbon copy of yesterday, with the exception being that we have more information.  Evan's LP (Lumbar Puncture, aka spinal tap) is scheduled for 10:00 a.m. tomorrow.  The medical team considered several options and decided to pull the PICC line completely, but not implant another one or a port at this time.  Everyone feels this will give his body enough time to clear out any remaining infections that haven't shown up on blood tests until his next IV based chemotherapy is scheduled in two weeks.  While under the OR team will also remove the sutures from his leg and perform an ultrasound on his previous port site in his chest to see if the clot has cleared.

It's easy to take standing for granted until it's a burden to do it.

     Speaking of chemotherapy, here is a brief synopsis of how we look for the next 40 days.  Evan will continue taking oral 6-MP (Mercaptopurine) until next Wednesday.  He's scheduled for one more LP next week and that will conclude Phase II.  After a brief 7 - 10 day break he will begin his next phase, although this one is subject to change.  Evan's primary oncologist feels that given his blood counts and the risk profile shown from his bone marrow results that paring back his next phase won't pose a significant problem.  For most patients Phase III involves increasing the dosage amounts until the blood becomes toxic.  Toxic?  What do you mean by that?  In short the dosage sizes would increase each week until his body was unable to recover the healthy blood cells.  Think of it as a medical approach to testing the bone marrow's limits for cell creation.  I don't know what his revised plan would entail, but we'll find out more soon.

Day 2 of school.  The dress code at Hayes is stricter than here.

     All of this sounded good to us, but what made it better was the prospect of giving us a release date of either later this week or early next week.  After he comes out of anesthesia tomorrow his vitals will be monitored and if everyone feels his BP, temperature, heart rate, etc. meet acceptable levels then they'll begin the discharge process.  Cristy and I have kept the house clean, with the help of some friends, but we'll almost certainly want to give it a deep scrub before feeling comfortable that it will be acceptable for Evan.
     What outstanding items remain?  Here is a rundown of what's left to be resolved:

• Continuation of physical therapy work on Evan's right ankle.
• Resolution of his on-going stomach pains, including the elimination of "loose" stools.
• Support his appetite and increase his caloric intake.
• Monitor his nausea issues and administer medication as needed.
• White-glove treatment of the house.

     None of these are life threatening so I don't feel too overwhelmed.  I will say that if we had to return home with the PICC line there were steps to prevent infections and clotting that could have been daunting and tedious.  I'd hate to have missed a step and put us back into a precarious position.