Day 201 - 2nd half of Delayed Intensification has started

     Today Evan and Cristy had a long day at the clinic.  The actual chemo administering probably totaled about an hour, but there are fluids that must be given before and after the Cytoxin which made this an all day affair.  We'll start the Thioguinine and ARAC tonight at the house.  Evan seemed to be in good spirits throughout and was a typical ball of energy when he got home.  The ARAC has a cumulative effect and we've been warned that Evan may start feeling poorly later in the week.

Coloring a book to pass the time.

     The Oncology team was able to answer a few questions for us regarding this phase.  Unfortunately it looks like Evan's hair will most likely fall back out due to these meds.  He didn't seem too concerned about it though since he sees that it will grow back in time.  We also discovered that his nadir will fall sometime in mid-January (10 - 14 days from now).  Even though he has the remnants of a cold, the staff seemed very comfortable with where he is health-wise and had no worries with moving forward with DI2.
     Following this phase, which lasts 14 days, his counts will be checked at the 21 and 28 day marks.  Assuming his counts are within expected ranges we'll begin Interim Maintenance on January 31st.  The doctor on staff today also reminded us that if Evan's hemoglobin counts get too low he'll need a blood transfusion.  This wouldn't surprise me too much since his hemoglobin numbers have always been traditionally lower than his other counts.

Working with some props at the clinic.

     On a positive note it looks like we'll be able to stop the Lovenox shots on January 12th.  Although his clot hasn't completely cleared out, apparently it's normal to conclude these sort of treatments after 6 months.  During his last MRI the clot had reduced in size, but was still there.  If/when Evan gets his port re-installed we may need to consider blood thinners again, but for the time being the medical team feels comfortable that the clot is not a risk to Evan's health.
     I don't plan on writing any more updates for the next week unless Evan has some adverse effects worth mentioning.  Evan next meets with ID on Jan. 10th, with another chemo session set for Wednesday.  He'll continue PT on Fridays, possibly increasing it back to two days a week.  With any luck the blog will remain silent until next week.

Playing Battleship with Mama during his infusion.