8:00 PM: I am pleased (and somewhat surprised) to announce that Sophie's counts are finally high enough to begin maintenance therapy. From now until May 31, 2007, Sophie will receive multiple 4-week courses of chemotherapy that will involve less-frequent visits to the clinic (for those counting down, that's one year, seven months). The following table summarizes the treatments for each 4-week (84-day) maintenance course:
|Vincristine||IV (intravenous)||Once every 4 weeks (in clinic)|
|Dexamethasone||PO (orally, twice a day)||5 days every 4 weeks (at home)|
|Methotrexate||PO (orally, once a day)||Once a week (at home)|
|Mercaptopurine||PO (orally, once a day)||Days 1-84 (every day--at home)|
|Methotrexate||IT (intrathecal--via lumbar puncture/spinal tap)||Once every 12 weeks and on day 29 for the first 4 courses (in clinic)|
We'll start tomorrow with a spinal tap (methotrexate) and vincristine and a fistful of prescriptions for the new oral medications. I'm sure you all fondly remember our run with dexamethasone (which is a steroid) during the fourth phase of treatment. Then, she took 21 days in a row, and we were all miserable. I'm pretty sure we started to notice effects within the first 5 days, but we are hoping 5 days will be a lot less disruptive and miserable for us than 21 days.
When she took mercaptopurine during the second phase of treatment, it didn't seem to bother her. The only inconvenient thing (other than the fact that she will be taking this medicine every day for the next year and seven months) is that it cannot be taken with dairy, so we'll have to make sure she avoids dairy for 2 hours before bedtime. We did discover that she doesn't mind chewing up the pill by itself, so we don't have to give it with peanut butter or applesauce or anything.
She's never taken methotrexate by mouth, so we don't know how she'll react to it (either the taste of it or the side effects)--we'll keep you posted.
What we're most excited about is that if her counts are still strong two weeks into treatment, she can start going to daycare. After a ten-month break, we're all ready to have her back. She tells everyone she sees that if her counts are high she can go to school. She's really excited about going back, and we'll start taking her in for visits very soon while we wait to see how she responds to treatment.
Randall and Elisabeth just got home from dance class. He has lots of reading to do tonight--we'll be getting the girls to bed soon so he can get to work. Sophie and I will have a very early morning tomorrow, so I'll try not to stay up too late.
Thanks, as always, for keeping up with us. It seems like we frequently hear from friends and family letting us know they read our updates often and look forward to hearing how we're doing. In fact, I just checked, and the index page for this blog was viewed over 1450 times during the month of October (at least a few of those times was us checking to make sure the entry looked okay or to see comments). That's great encouragement for us, and great prayers and positive thinking for Sophie. We welcome and treasure it!