Round Three Tea

Mom’s third round of chemotherapy comes to an end today. Here are some thoughts about the experience, with one eye looking at how things compared to rounds one and two and one eye looking at what’s next.

Chemo Day

On Tuesday, May 17th, Mom, Alia, and I set out for Penn’s Abramson Cancer Center to meet with Mom’s provider and settle in for 5-hours of infusion (chemo).

To avoid being sent home with low white blood cells (WBC) again, Mom had bloodwork done at a local Labcorp the day before. While it took over a day to get the results, we did get them before we left, so we knew the WBC would not be an issue this time. For those of you keeping score at home, Mom’s WBC was 5.1, and her ANC was 2.3. The numbers were lower, but they were well within range.

The first part of the day involves meeting with Mom’s provider, Abigail Smith, CRNP, MSN. Abby works for Mom’s primary oncologist, Peter J. O’Dwyer, MD. We generally meet with Dr. O’Dwyer every four infusions and meet with Abby during the other infusions.

Abby told Mom repeatedly that Mom was doing amazing. She said Mom’s numbers were fantastic and that the dosage adjustments made after round one seemed to be working great. Mom’s vitals (blood pressure, weight, etc.) were excellent. Abby ordered a CT scan after round four in a few weeks and ordered an appointment with Dr. O’Dwyer to review it; she also suggested we schedule Mom’s rounds five and six for after that.

We’ve developed a pretty good routine for these chemo visits; Alia and I and Mom make a nice team.

Around noon we were assigned a room for infusion; the nursing staff in the infusion wing were incredible (as always). The hours passed without incident, and much criticism of whatever was on HGTV. The “coastal look” is cool and everything if you are, you know, on, or at least near, a coast; it is silly when you are a few hundred miles inland from any saltwater. Anyway.

Mom’s chemo is called FOLFIRINOX, and it is actually three different kinds of chemo; they administer two while at Penn and hook up the third to a small pump that Mom has to wear at home for 48 hours, which is fun for Mom.

When the first two parts finished, we packed up and headed for home. The prescription I should have ordered days ago was finally ready, so we picked that up and were settled in for a late dinner.

Two of Mom’s granddaughters slept over that first night, and we have family scheduled for sleepovers for the rest of the week.

Later this afternoon, the at-home nurse should arrive to deaccess the chemo from Mom’s chest port and hook up some IV fluids, a wrap on round three.

The Past

We don’t want to get too hung up on looking for repeatable patterns. However, I can’t help it. I color-coded each day as Good, Medium, or Bad for Mom since she got the diagnosis. I also colored the chemo days. I set up a page on this website to display them all.

I hope that, perhaps, some pattern might emerge. I know we have to take each day one at a time, but I also believe you can manage anxiety and stress if you can create a framework of expectations. I think sometimes fear is a pain amplifier.

Here is what the grid looks like now:

The sample size is too small, but still, it appears Mom has maybe four good days after chemo followed by a bad day, followed by a string of good days. 

We’ll see if this pattern holds at all.

The Future

We scheduled Chemo 4 for a few weeks from now; we’ll continue to get the bloodwork done a day or so before at Labcorp. 

Then, in June, Mom will have a CT scan done to see what impact the chemo has had on her tumor. It is possible that the tumor may have shrunk, is the same size, or continued to grow. Some of those options are better than others. We will meet with Dr. O’Dwyer to review and determine if we make any changes to the chemo cocktail Mom is currently on.

So, we’ve marked up the appointment calendar through July, with some significant events in the next few weeks.

Your continued prayers, wishes, and support are welcome and needed; this is a marathon, not a sprint.

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