72) Flu fighters

I've never been an anti-vaxxer. Vaccines save lives. Full stop. I will admit that in the past, I haven't always gotten the flu shot. I'd tell myself things such as: "I'm young", "I'm healthy", "I practice good handwashing & hygiene", "I don't need it". Well, I've reformed my ways, and for at least the past 5 years, I've rolled up my sleeve to get vaccinated come October. I've been thinking about writing about this subject for some time, but wanted to wait until it was closer to the time when flu shots are available. I've also doubled, and tripled down on the importance of getting the flu shot, particularly after E's leukemia diagnosis, and also after reading about an Ontario woman's heartbreaking flu story.

While you, and I may be young, healthy, and in the lower risk group when it comes to influenza, not everyone is. Babies, children under 5, adults over 65, pregnant women, people with underlying health conditions such as heart disease, or diabetes, and immunosuppressed people such as cancer patients are all most at risk of complications from the flu. You're not necessarily getting the flu shot to protect yourself, you're getting it to protect the most vulnerable segment of our society. Think of getting the flu shot as the ultimate form of altruism. We're basically using the principles of herd immunity to protect the most at-risk segment of the population from infection.

Admittedly, the flu shot is not 100% effective, but research shows that even partial immunity can reduce the length & severity of symptoms should you contract the flu. The flu shot contains inactive strains of the flu that researchers believe will be circulating in a particular year. Because these viruses are effectively dead, you will never get the flu from the flu shot. It does take about 2 weeks for your immunity to build after having received your vaccinations, and in those 2 weeks you are still vulnerable, so ensure to get your flu shot early!

If you do get the flu, drink lots of fluids & get plenty of rest. Avoid caffeine, alcohol, and tobacco products. Gargle with salt water, and use a saline spray on stuffy noses. Most importantly, if you have the flu, STAY HOME. Being the hero that continues to soldier on to work will only accomplish one thing: passing on the infection. Given that you are contagious before you show any symptoms, anyone you've infected will continue to pass along the flu. Then those people will pass it on to someone else, who passes it on to someone else, etc. until someone from an at-risk segment of the population is infected, and ends up in the hospital or worse.

Part of the reason I'm writing this is selfishness. With E being a leukemia patient, he falls into the high risk category for potential complications from the flu. Another part of the reason I'm writing this is selflessness. The older I get, the more I feel that it is our duty to society. We owe it to ourselves, as well as our fellow citizens to vaccinate against the flu in order to best protect everyone. In Ontario, it's still a bit early, and flu shots are not yet available, but it's not too early to start the conversation. This fall, one by one, we can all be flu fighters if we get vaccinated, and get vaccinated early. The life you may be saving could be my son's.


Find a flu clinic near you:

http://www.healthycanadians.gc.ca/diseases-conditions-maladies-affections/disease-maladie/flu-grippe/clinic-clinique-eng.php


Flu facts:

https://www.ontario.ca/page/flu-facts

https://www.canada.ca/en/public-health/services/diseases/flu-influenza.html

https://www.forjudeforeveryone.com

71) Fire!

Today is bloodwork day. Or it was supposed to be. We were minutes away from leaving the house to drive to the satellite clinic when the phone rang. My wife answered, and it was E's nurse practitioner who told us not to come today. There was a fire in the hospital on the 3rd floor, and management was advising the public to avoid all non-urgent visits. So, we've been rescheduled.

70) Medication adjustment

The very first oncologist we met after E's diagnosis explained leukemia, and the course of treatment. I mostly remember his words, and they went something like this:

"With a leukemia diagnosis, something has gone wrong with the bone marrow. Instead of making regular cells, the process has become defective, and the result is an overabundance of blasts. The course of chemotherapy reboots the system, and keeps it artificially low for a couple of years in order to fix the defect so that the bone marrow starts producing cells normally again."

Over the course of treatment, the patient will receive copious amounts of blood tests. It's important to monitor the state of different types of cells in the blood, because you want to ensure that levels for things such as white blood cells, neutrophils, platelets, etc. are in the Goldilocks zone - not too high, and not too low. Counts that are too low increase the chances of bleeding or bruising, and increase the risk of infection. Counts that are too high increase the chances of relapse.

E is currently in the maintenance phase, and he has bloodwork done every 2 weeks. The last 3 times, his neutrophil counts have been slightly higher than normal. SickKids makes a medication adjustment when they observe 3 consecutive higher results, and now that's what happened to us. When last week's results came back, and the neutrophils were again up, we received a message from our satellite clinic to increase his 6MP. He used to get half a tablet 4 nights a week, and a full tablet 3 nights a week. He now receives half a tablet only 3 nights a week, and a full tablet 4 nights a week.

Am I worried about this development? I don't think so, not overly. I don't believe either SickKids, or his nurse practitioner are worried about the climbing counts. He's 2. He's growing. Eventually, medications are going to have to be increased to account for the change in his body mass.

I'm not doing cartwheels that we have to increase the dose of a medication that is toxic to the point where we have to handle it wearing a mask & gloves, but I'm relieved that the likely cause of the increase is a growth thing, and not a leukemia thing.

69) The tacklebox

We have a tacklebox:

It's not for fishing, but it is important. Anywhere we take E, the tacklebox goes with us too. As you can see, it's packed with pretty much all of his medications, and a number of other things:

It has EMLA patches to apply to his port. They numb the skin so that it's less painful when he's accessed with the needle. It has a couple of chemo drugs: 6-MP (mercaptopurine), and methotrexate. It has an anti-nausea medication called ondansetron which is given in conjunction with his doses of methotrexate. It has a pill cutter, and tweezers because E gets half a pill of 6-MP some nights, and a full pill on others. It has cotrimoxazole (Septra), an antibiotic given as a preventative measure against a form of pneumonia to which cancer patients are susceptible. There's a pill crusher to grind the aforementioned Septra pills into dust so we can mix it into puréed fruit or applesauce. There's acetaminophen (Tylenol) in case E is in any pain, such as the jaw pain side-effect he usually experiences from the bi-weekly doses of vincristine. It has to be acetaminophen, since cancer patients need to avoid ibuprofen. There's a couple of thermometers to test for fever in case he feels warm, a few clean, empty syringes for administering doses of medications, and drug information printouts that contain important information about dosages, instructions, and possible side-effects.

The tacklebox & lock were given to us by SickKids because of J. SickKids wants to minimize the chances of a sibling getting in to, and accidentally doing damage to themselves by ingesting these toxic drugs. It's always kept locked, until we need it.