Start of Delayed Intensification and Happy Birthday

Today was day one of "Delayed Intensification" and was also Carter's birthday.  It started off with a sedation for Intrathecal Methotrexate (injected into his spinal fluid) which meant no birthday breakfast.  When we first got there, the lady at the front desk (who has been kinda rude to us on a previous visit) gave me some attitude about being late.  I guess they had my appointment as being at 8:00 but my appointment paper and reminder call both told me 8:30.  Then the triage nurse came to get us and more attitude was thrown my way for being "almost an hour late!"  Carter was already really sad that we had to be in the hospital and that was pretty much the last place I wanted to be also, so by the time all this happened and we finally got to our room I was feeling very frazzled and upset.  The sweet nurse came in to do Carter's access and draw blood for the CBC.  She could tell I was on the verge of tears and asked me what was wrong.  I started crying and told her about the appointment mix-up and everything.  She was very nice about it all.  Anyways, then she needed to do the access and Carter was not having it.  He climbed under the chair in the corner to hide - that's a new one.  I had to move the chair to get him and hold him down for the access.  Now I have a few scratches on my arm, it was a rough morning.  During this craziness, my least favorite Doctor came in to do his exam.  The nurse told him she'd come get him when she was finished and he acted very put out - we were running late, after all!  I was not excited that we were on his schedule.  Once he was access and the blood was drawn and he was calmed down, our doctor came in.  Carter's official doctor.  I could've jumped for joy at the sight of him.  He talked with me for a little while and helped us both feel better.  Then we got some zofran and were off to the playroom.  He got to play for a few minutes before they came to get us for the sedation.  I had to carry him to the room because he tried to run away.  He cried until he finally fell asleep.  While he was sleeping I took a little walk outside to regroup (sorry, this is turning into a mommy-venting post) and when I got back, Carter's chemo pal was there.  We talked while we waited for Carter to wake up.  He got both of his chemo meds while he was still sleeping and started to wake up right as the nurse was going to de-access his port.  I told her to just hurry and do it quick before he was all the way awake.  She got the tape off and needle out so fast!  I picked him up and started talking about birthday cake and showed him his friend was there to see him.  He looked down and his chest and asked, "is my tubey out already?!"  From there on out, he was a happy little 4 year-old.  The nurses came and sang "Happy Birthday" to him and he had birthday cake for breakfast.  He played with his chemo pal for a little while and even got a few new toys from him for his birthday. 

 

Chocolate cake on his face and a new airplane toy

Then we had to go down and pick up some meds from the pharmacy.  We stopped by the fish tank and read a few books while we waited for it to be ready.

 

He wanted Carl's Jr's chicken stars and a milkshake for lunch so we picked some up on the way home.  He put the straws in like this and told me it was so we could both drink at the same time :)

We played outside, went to the store, visited the fish hatchery, had waffles for dinner, and watched the rest of the 4th Shrek movie.  The day ended well despite it's rough start.

Here's a list of the medicines he'll be getting this round.  He's had some before.  The ones he hasn't had are very similar to ones he has.

Vincristine - he's had this one every round so far

Peg-Asparaginase - leg shots, had first two rounds

Cyclophosphamide - all day clinic visit, has had before

Cytarabine - I inject into his port at home for 3 days, has had before

Intrathecal Methotrexate -  into spinal fluid, has had last two rounds

Dexamethasone - steroid, similar to Prednisone, some say it has stronger side effects

Doxorubicin - very similar to daunorubicin which he's had before

Thioguanine - I forgot to ask him about this since he won't get it til next month but I think it's similar to the Mercaptapurine that he's had before

He got Vincristine, Intrathecal Methotrexate, Doxorubicin, and Dexamethasone today.  He'll be on the steroids for a week then a week off then a week on again.  He'll get the leg shots on Monday, the Vincristine and Doxo again on Thursday.  A week after that he'll get them again and that will be the last of the Doxo.  Yay, that one sucks.  Next month is more craziness and I'm too tired to tell you about it now, you'll have to wait :)  Lots of drugs, lots of clinic visits, and like we tell Carter, it will all make his "dragon" smaller and smaller and smaller until he can finally squoosh it.  I think we'll have a giant party for that...

His blood counts, if you're curious, are looking awesome.  White blood cell 3700, ANC 1500, hemoglobin 12.8, and platelets 396,000.  I kept forgetting to post them for all of last round but they were always pretty similar to his - didn't fluctuate much.  They will start to go down again soon with all this medicine they're pumping into his veins.

Carter is the srongest 4 year-old I know!