09/22/11 Phase One ---- Check!

Good news - we have successfully completed Phase One (of seven)!  Starting tomorrow, Adam is officially in "Consolidation." The purpose of consolidation is to make sure the cancer is fully in remission and stays there. We thought it would take days, maybe even weeks for Adam to qualify for the consolidation phase.  To qualify, his ANC levels (white blood cell/immune system count) needed to go back up to 1000, and last week he was only at 290.  A "normal" ANC is 1500.  So, when we heard 290, we were ready to pack up and admit ourselves to the isolation ward again!  Last Friday, his dose of chemo was a little lower than we've had in the past and just the small relief helped his body fully recover. After our blood test yesterday, Adam's ANC is now 2000!  What a difference!  Luckily, once again, we have a rapid responder.  So, of course the nurse called us right away to inform us that his treatment tomorrow will be the new consolidation medications. Who would have thought celebrating Adam's first time qualifying for something with take-out pizza and brownies would be for qualifying for new chemotherapy!  A milestone is a milestone, I guess. I'll take what I can get :)

I learned something else new in my research tonight: "When a patient is diagnosed with ALL, he or she may have 100 billion leukemia cells. If induction therapy destroys at least 99% of these cells, the patient is in remission. However, that could still leave 100 million leukemia cells in the body. If these cells are not destroyed, they can grow and multiply and cause a relapse of the disease" (www.marrow.org).  100 billion!  I had no idea the numbers we were dealing with.  Once you're talking above a million, it's kind of difficult to comprehend because there is not much to relate a number that large to. However, I do know that 100 billion is twice the amount of money Bill Gates has (I'd much rather have $53 billion rather than 100 billion cancer cells - call me crazy).  So, now I'm curious.  I can't find the exact number of total blood cells in a human body, but I found a source that says a "normal" adult has 30 trillion red blood cells. Coincidentally, that's twice the amount of the national deficit!  Ok,maybe I've gone too far.  Back to Adam...

Good news is we can check something off.  It feels strangely productive to be moving into a new phase.  Bad news, everything changes.  You know how I feel about change.  It is very likely Adam and my cooking marathon will be ending soon.  A common side effect of the new medication is nausea.  It is possible he won't eat for full days at a time!  As for the most obvious physical change (hair loss), I wouldn't say he is losing hair per say, but possibly thinning hair.  The hair cut makes it hard to tell.  I think we might be several weeks (maybe months) from complete baldness.  And we need to watch his skin for darkening or rash (he is also super-sensitive to sun.  Thank you September heat wave for your great timing).  It is also common that he will need a blood transfusion sometime this month - this chemo specifically depresses the bone marrow, so his counts will be low, and possibly not able to recover naturally.  So far, everything has been surprisingly manageable.  It's nice to still have a schedule for clinic visits (every week on Fridays).  In this next phase, we won't be accessing the metaport every week, instead spinal injections of Methotrexate.  We are also changing from 3 pills, twice a day to only 1, 1 time.  Our new pill is Mercaptopurine - its purpose is to block the growth of cancer cells.  We continue the anti-pneumonia med on the weekends though - we will always take that during our three years of chemo.  Thank you for your prayers - we are definitely lifted!!  Time to read one of our favorite books - I am being beckoned.  G'nite!