Looking ahead.

Watts woke up happy this morning after two hard days of crankiness. Every time we come home there seems to be an adjustment period and this time was no exception. We celebrated his cheerfulness (and a neupogen-boosted ANC) with brunch down at Sticks and Stones (best biscuits ever!) and some deep sighs of relief.

We will check counts again on Monday and possibly start the next round of treatment on Wednesday or Friday of next week.

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I've gotten a lot of questions about what treatment looks like now that we've made it through the HD Ara-C stay. Well, treatment is far from over but Watts has made it through the most intense part, Lord willing. We are now waiting for counts to recover and then we will start the next round of treatment called Continuation I.

On day 1 of Continuation I, he will get Triple Intrathecal Therapy (a spinal tap) of methotrexate, hydrocortisone, and cytarabine. He might also have a bone marrow aspirate but the doctors have not made a final decision about it yet. After the spinal tap, we will go back to clinic and he will get the chemo drug, Vincristine (IV push over 1 minute). At home we will start back on steroids and continue for five days. For the three weeks following the steroid week, he/we will be going to clinic weekly for chemo (IV lower dose Methotrexate) and we will be giving Mercaptopurine to him twice a day at home.

We will repeat this four week cycle (spinal tap/steroid week followed by three weeks of IV MTX and MP) two times then we will admit for an Etopside five day hospital stay, followed by some recovery time at home.

After that, we will do the whole 8 week cycle all over again and end with another Etopside five day hospital stay. That stay will be our last scheduled inpatient stay! After Continuation I, we will start Continuation II (aka Maintenance) which will last for a full year.

Confused yet? To complicate the matter, IV MTX and MP are count dependent, so we may be skipping some weeks and/or getting delayed. We will be holding our calendars very loosely, as usual.