Delayed Intensification
as the name implies, is a more intense phase of treatment for
leukemia. One of our oncologists referred to it as a phase where the
chemotherapy is analogous to "going after the cancerous cells
with a sledgehammer". It started November 29th, and was
scheduled to conclude and move on to Delayed Intensification II on
December 28th.
Poor little E had a lot
thrown at him in the month of December. He had a week-on, week-off
schedule of a steroid named dexamethasone, a drug named
PEG-asparaginase which can potentially cause anaphylactic reactions or
strokes, as well as weekly injections of vincristine, and
doxorubicin. Doxorubicin is one of the new drugs this month, and E
needed to be given an EKG before it was given because it can
potentially cause heart problems when given in higher doses.
For most of the month,
there were colds and sicknesses in the house. I had a stuffy nose and
sore throat off and on throughout most of December. J brought croup
home from daycare. My wife was also intermittently under the weather.
But the month kept chugging along. E started getting a cold and a
runny nose. Around the 13th, E's hair started falling out. It had
previously fallen out during the first month known as Induction, but
it had slowly started to grow back. Just touching his hair would
cause it to drop, and for a few nights in a row, there were clumps of
hair left floating in the water when his bath was done. More cracks
started to appear, and the week beginning December 18th, we began to
suspect something was up. E wasn't smiling as much, he wasn't
babbling as much, and he seemed worn out. The dexamethasone was
finished on the 19th, and we took E for a scheduled blood test at our
satellite hospital on the 20th. Returning home from our blood test, E
fell asleep for a couple of hours with me on the chesterfield,
something he never does. Overnight, from the 20th to the 21st, E
really wasn't feeling well, and in the early morning hours, he came
down with a fever. A fever in an oncology patient means you are
likely going to be admitted to the hospital for 48 hours minimum.
At the hospital, blood,
and urine samples were taken so that cultures could be run on both.
Being immunocompromised, it is potentially dangerous if E were to
have a bacterial infection. Bloodwork showed that his neutrophil
counts (a neutrophil is a type of white blood cell that is important
for fighting infection) were below 0.5, meaning he was neutropenic,
so we would be admitted to the hospital. Antibiotics are started
right away, in case of bacterial infection. When the blood and urine
cultures come back after 48 hours, antibiotics are either continued
or stopped, depending on whether a bacterial infection is found.
Delayed Intensification
II is supposed to be worse than Delayed Intensification I. Due to E's
fever, and hospitalization, Delayed Intensification II has been
pushed back a week, but it makes me worry about getting through the
next 28 day phase.
Having to be admitted to
the hospital with E just 4 days before Christmas was disappointing.
My first priority was for his health and well being, but I was also
feeling a lot of stress about things happening at home. We'd received
a dumping of ~15cm of snow, so the driveway & sidewalk needed to
be shoveled. Also, we’d fallen behind on laundry, presents needed
to be wrapped, last minute items picked up, groceries bought, and the
house tidied up since we were supposed to be hosting Christmas Brunch
with my wife's side on the 26th. My wife and I decided we would trade
off nights at the hospital with E, and at home with J. December 21st
was the first hospital shift, and I stayed with E. My wife would go
home with J.
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