Tuesday, December 2, 2008

Consolidation 101!

Good morning!
We can all celebrate that Lizzy is entering The Consolidation of treatment!
The goal of consolidation is to get rid of each and every teeny, tiny, minute, even undetected blast! Consolidation lasts 57 days...roughly 2 months. The difference in Consolidation -vs- Induction is that now Lizzy is off of 2 initial chemo meds and will be started on 2 new ones. And, 2 of the chemo meds will remain the same. Additionally, if I understand it right, she will be off the prednisone..so Panera may not be getting quite as much business...(Or Chipolte, or Bone Fish Grill etc...!)

Consolidation starts over with Day #1. Lizzy was to start Day # 1 today, but yesterday, after the home health nurse came to draw her blood, the Docs called to say that Lizzy's ANC was too low, so she will need to wait a week. ANC = Absolute Neutrophil Count = Good, infection fighting white blood cells. Lizzy's ANC must be 750 or higher to get chemo. (If she is in the hosptial, it has to be 500 to be discharged.) Yesterday her ANC was 360. When her ANC is low, she is much more prone to infection. The chemo is working on the bad cells (blasts), but it also hits the good cells...so this is the dance... the chemo/counts dance. It is a bit frustrating b/c just when you think you are on track...the counts can hold you back...but to be safe, Lizzy's ANC needs to be 750 or higher to get the chemo. So, waiting a week is a bummer, but not unexpected.

Additionally, if Lizzy gets a fever she will need to, immediatly, go back into inpatient for antiobiotics. This is a fine line...they thought she may have to go back in yesterday...not for chemo....but b/c her ANC was low, and she is much more prone to infection. The new buzz word we all need to be familiar with is Fever Neutropenia This refers to low counts (ANC), with a fever. It is not all bad, and can be quickly treated, but it also can be very, very serious if Lizzy gets sick, and is not able to fight infections. Thus....when her counts are low, like they are now...she may have to go back to hte hospital immediatly. And, if we go to visit her, even if she is at home....we HAVE TO WEAR A MASK! (More on that later!)

Lizzy's Platelets and hemoglobin were good yesterday! As a matter of fact, this is very, very good! When Lizzy was in the hospital, you may remember that she would get transfusion of platelets, but her platelet levels would not remain high for very long. Futher testing showed that her body was recognizing that the tranfused platelets were not her own....so her body attacked and destroyed them. The platelets are very, very important as they are the clotting factor that prevents bleeding. Now, however, Lizzy is making her own platelets!!! Her Platelet count yesterday was 175K, up from 117K when she left the hospital. Her platelet count only has to be 75K for her to proceed with the lumbar punctures. (Spinal tap)

Lizzy's hemobglobin was 12.5 yesterday. If she were in the hospital, it would need to be 8 to be discharged. The hemoglobin is what transfers the oxygen throughout the body. (Kind of an important job!!)

So, all in all, Lizzy is doing well. It is dissapointing though, that she was not able to start Consolidation today. She is now scheduled to start Day #1 on December 9th. The process for consolidaiton is Inpatient for 2-4 days every 3-4 weeks. Her Inpt. stays will start with an early morning trip to the clinic (Which is on the same floor as the oncology unit I think)....today she was to be there at 6:45.... She will get a LP (Lumbar Puncture), they will draw spinal fluid and give her chemo IT (Intrathecally = in her spine), then she will be admitted the 2 new IV chemo meds. In between LIzzy's inpatient visits, she will visit the outpatient clinic each Tuesday (And sometimes Friday)...for boht IV and IT meds. Additionally, Lizzy will also be taking meds by mouth daily, either at the hospital or at home.She will continue to be monitored closely via blood draws to check her counts....I am not sure how often, but my guess is daily either at the hosptial, or a Children's outpatient satellite (Mason?), or with the home health nurse.

As I talked to Christine yesterday, she mentioned that this routine in now the "new normal." She said she has their bags packed and ready to go inpatient on the drop of a dime. If Lizzy gets a fever, or her counts get too low, or she has a big nose bleed etc...off they go to Childrens. Christine also mentioned that she believes with Consolidation being pushed back a week, that Lizzy will now probably be in the hospital on Christmas. December's slogan is "Have Christmas Tree...Will Travel!!!" Of course, this is not what anyone would want, yet, the Lothrops have a peaceful / "Can do" attitude!

Alhough I have a little more I would like to share with you, I will close with this declaration from Christine aka: Mama Doctor Bear...
aka: BOUNCER! There is a new slogan in the Lothrop home...a new strategy....it is called THE DELAYED HUG STRATEGY! It goes like this....1) Get a flu shot, 2) Wash you hands IMMEDIATLEY upon entering the Lothrops home, or hospital room (There is hand sanitizer just inside the door both at home and at the hospital) 3) Put on a mask 4) Give Lizzy a huge {{{HUG!}}}!!! Additionally, if you have been around anyone sick at all, in any way....pls. do not visit....home or in the hospital...virtual hugs are good....but not in person. Espeically now, winter, flu season... we are all around lots of people...we are all suseptible to those bugs....lets purpose NOT to bring any of it into the Lothrop home! All of this is SO important as you never know where Lizzy's counts will be one day to the next...

Thank you for your prayers and acts of love and practical support!
Christine is concerned b/c Lizzy is so beautiful and vibrant on the outside, yet a raging unseen battle is happening on the inside. Let us not be fooled, or passive. Please coninue to pray unceasingly for Lizzy's continued healing and protection. I told Christine yesterday that when I think of Lizzy throughout the day, I pray...and I just automatically wash my hands...!!!Image Blocked

Lets' Keep praying....
Thank God for Lizzy's increased platelets and hemoglobin.
Thank him for a wonderful Thanksgiving at home.
Thank him for the meals, and acts of love and kindness extended to the Lothrops.
Thank Him that Christine can be home with Lizzy!
Pray for:
Increased protection from infection
That Lizzy will be able to start Consolidation on Tuesday the 9th.
That Lizzy's platelets and hemoglobin will continue to hold, and that her ANC will come up.
Continued Peace that passes understanding...

Thank you for your encouragement as you join the Lothrops on this journey


PS - Orange is THE "New black" on Tuesdays!!
PSS - Mama Doctor Bear...aka: THE BOUNCER asks you to strictly adhere to the new DELAYED HUG STRATEGY...or risk being ejected...!
She is a Mom... we need to consider ourselves duly warned!!!!


Melissa Lohman Grablovic said...

Hey! I really appreciate you guys continually updating this blog. It helps everyone to understand what's going on, and has become part of my daily routine. The kids are still asking about you and hoping you'll come back to school soon! We're praying for you as you embark on this new journey!



Lisa said...
This comment has been removed by the author.
Lisa said...

See. . .I knew better than to come. I have been afraid of passing my germs but now I know that even though it's my friend at work sick I better stay away. Please know, Lizzy, that I am thinking of you always and praying for you often. . .and am only 1 house away if you need anything (i.e. homemade veggie soup!)

Tell mom Hi! and I'm sending my love,

Lisa Bargo

The Quigleys said...

Hi Chris and Liz,

I'm praying hard for good results today! Thank you Deb for always helping everyone in understanding what is going on! Lizzie just keep the faith..
Love Aunt Cec