May, 2004

Well, we're home.

This week Nate finished the 3 weeks of steroid (and vincristine, and daunorubicin) that are the first half of his delayed intensification (DI) stage of chemo. Wednesday morning was the last dose of dex, and boy were we happy for that! We wanted our son back. I've been calling him Senior Loco, since the steroid side-effects change his personality. He ballooned up the last week on steroid... on Wednesday in clinic he weighed in at 59.7 lbs... just huge. And, he was at the point where he could barely walk, couldn't get up or down to the floor anymore, couldn't climb a single step on his own. Kind of like at the end of Induction. I guess that's why this stage is called Intensification

His labs on Wednesday looked ok (CBC primarily), so we went home without even seeing his NP or doctor. Thursday he was continuing to swell, even though we had stopped the steroid the day before. And, he started complaining about it hurting when he urinated. His scrotum had swelled up, and looked like a water balloon. So, Christa took him in to see the doctor. Dr. Marina checked him out, and she decided she didn't want to just give him lasix (a diuretic) and send him home. So, she admitted Nate to the hospital. This was about 5:30 pm on Thursday. I went by the house on the way there to pick up clothes and toys, etc.

The blood test results on Thursday showed his BUN was high, some other liver functions tested high, his albumin was low, and his triglycerides were sky high (> 3000, normal is < 150). I guess his fluid issue, and other stuff was a bit interesting, because several of the senior oncologists all checked on him. He had a chest and abdominal x-ray Thursday night, but we'd have to wait until morning for an ultrasound. But, there wasn't a plan on what to do, other than to keep monitoring him. So, Nate and I settled in for the night.

A fasting blood test at 8am on Friday morning showed that his BUN had dropped a bit, his triglycerides were down to 500 (still several times normal), his cholesterol was high (expected based upon the triglycerides level). His albumin was still low. An ultrasound was performed in the morning, and there was no obvious pooling of fluid in his body, just swollen tissue apparently holding onto too much water.

Dr. Marina came by and she talked about what the plan was: give him an infusion of albumin, and follow that with lasix. The albumin should draw water from the tissue into the blood, and the lasix would cause the kidneys to remove the fluid from the blood with increased urine production.

So, a lot of time was spent hanging out, waiting for the albumin to be prepared for the infusion, starting the infusion, and then giving him the lasix injection. I snuck out for a while, went home and got cleaned up, then headed back to the hospital.

This seemed to help, and he started to loose the fluid. But, it takes a while, so we spent another night in the hospital. At 5am a nurse weighed him (Why did they do it at 5am? Because they can.), and he had dropped 4 kilos (8.8 lbs) from Thursday evening. You could see in his face and his belly measurements (they measured his girth several times).

Dr. Marina had indicated on Friday evening that he should be able to go home on Saturday morning... well, morning is a relative term. Saturday morning when she came by on rounds, she decided that we should do another albumin/lasix round. And, since his blood pressure rose a bit during the albumin infusion, they decided to watch him for 2 hours after the drugs were administered. So, after loosing even more water, he finally got to head home after 6pm Saturday.

Of course, life can't be this easy... Nate decided he couldn't sleep so he was up until 10:30pm, Andrew woke up about 9pm from his sleep crying hard, then managed to puke all over Christa. Why would life be simple? That would be too easy.