clinic 10/27

We went in for our monthly clinic visit on Thursday.  Carter's counts are looking good still:  White blood cell count 3000, ANC 2200, Hemoglobin 10.9 and platelets 324,000.  They want his ANC to stay between 750 and 1500 for the duration of his treatment.  If it's still higher than 1500 next visit they will probably increase his dose of oral meds to drop it down a bit more.  So that was all good but the rest of the visit was not so great.  His port access went great but the nurse couldn't get the port to work at all.  They often have trouble drawing blood from it so they end up putting heprin in to sit for about 10 minutes or they use TPA (which sits in there for about an hour) which breaks up any clots that might have formed around the end of the tubing in his vein.  But despite the blood drawing issue, they've always been able to flush it with saline.  Well this time she couldn't get even a drop of saline to push in.  We've never had this problem before.  Since we can't get anything in, there's really no tricks they can use to get it working.  She tried to get some TPA in using a "pressure method" but it didn't work.  They had to start an IV in his hand to draw blood and administer his chemo.  He was not happy about that.  It was awful. 

 

SOOOO..... Since the port is no longer working, Carter will have to have surgery to remove it.  And now we have to decide if we want another port placed or if we want to just do an IV every month.  There's benefits to both ways.  Not having a port means this would be his last surgery.  They also wouldn't get quite so excited about fevers since they are mostly worried about an infection from his central line.  Doing an IV each time and putting chemo through those smaller veins could do damage to them.  And he's so used to his port getting accessed that it's no big deal and our clinic visits are usually pretty easy.  I don't know how long it would take for him to get used to pokes in his hands.  But having another port put in scares me a lot.  I remember the last time when he had this one put it, it was terrible.  One of the hardest things he's been through.  The recovery from that was rough, he was so sore for a long time.  Not to mention he did get an infection and was hospitalized that night.  Ah, I just don't know.  

But look how far he's come!  This was in Feb when he was still chubby from a month of steroids:

 

Doesn't he look amazing now?  He just looks so much older and more mature.  And he definitely is more mature now.  He has certainly grown up a lot over these past 10 months.  He's really amazing.