Day 28 - Final day of Induction... (sort of)

He liked his Daytona Beach hat... :)

Today was the final day of our induction phase.   We were scheduled to have our bone marrow test and our final dose of chemo through Ryan's spine today.  However, as usual, Ryan has different plans.  They got the bone marrow test just fine, which was probably the most important part of the day.  This will tell us how much Leukemia is still in his system and will help us determine how the next 8-10 months will go.  Unfortunately, it's a Friday, (and a holiday weekend) and we shouldn't expect any results until next Tuesday.  Which kinda sucks as I'd really like to know what to expect.

Next, they tried to do the spinal tap to give him his Chemo.  However, the tech could not get it.  She tried 3 times, and then called someone else.  The 'someone else' tried another 3 times, and then called someone else.  That 'someone else' tried another 2 times, and then they gave up.  Yes, he was completely asleep through this (thanks to the magic of anesthesia).  However, at this point, they decided that they needed more help, with Interventional Radiology (IR).  IR will be able to scan his back while they are trying to get the spinal tap, and make sure they are in the 'right place'.  Unfortunately, it's a Friday on a holiday weekend.  Needless to say, we won't be doing the final chemo until Tuesday of next week.

Some of the fluid is getting off him, but he's still really puffy.  We are finishing up the steroids tomorrow, so that puffy-ness should start to decrease by next week.  He also has an appetite, which is awesome.  He got some meds for the pain, but he also ate a good lunch and dinner.  

He was pretty tired when we finished sticking needles in his back, so he kinda rested for the rest of the day.   As for Patrick and I, we were 'trained' on how to take care of him, when we do finally get to go home.  First, we had training on what to do if he gets sick while we are at home.  (i.e. if he gets a fever, call them.  If he looks like crap, call them.  If he falls down, call them.  etc...)  Then we got a little help on some physical therapy exercises that might help him.  And finally, we got about 2-2 1/2 hours of training on how to care for a central line.  (it's not like we've been dealing with a central line for the last 13 years)  To be fair, the last trainer from the home care was really awesome and we had a lot of fun.  She was also British, which just added to the enjoyment as we were all a little sarcastic towards the end...

This was my first day getting to meet the team, which was great.  Everyone was really nice!  Of course, I'm sure Patrick just told them wonderful things about me... 😄

We might get some special visitors this weekend, which I'm sure will make Ryan very happy.  Otherwise, no tests, no chemo and nothing else to do.  We're still planning on discharge mid next week, so hopefully, all goes well!  And, to top it all off, Patrick and I walked up the hill about 2 miles from the hospital to the apartment, and I only cursed a few times.  It was actually a really good walk and Patrick made me buy new walking shoes, so my feet are only slightly bruised... After another 8 days of this, I might be able to make that walk without cursing (... yea, right...)

Thank you all for the prayers and good thoughts!!

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Blasts - (not checking this every day anymore)
ANC - 185 (Patrick and the Fellow are betting on whether this will go back down to 0)
Hematocrit - 24.1
Hemoglobin - 8.2
RBC - 2.69
WBC - 0.4
Lymphocytes - 166
Creatine - 0.2
Glucose - 99 (apparently, no one is concerned about this anymore..)
Platelets - 76
PT - 16.1
APTT - 34

Description of lab numbers, in layman's terms:

Blasts - roughly the number of leukemia cells found in the sample.  We want this to be 0.
ANC -  This tells us how well his body can fight off normal infections... We want this to be greater than 500..  Normal would be greater than 1500.
Hematocrit/Hemoglobin (H&H)  - This is a number of how much blood is in his system.  His normal range is 28-32/9-11.  The numbers are linked, so they are usually referenced together.  We will transfuse him more Red Blood Cells if he gets below 21/7.0.  (this is the blood you donate at blood drives, and we expect to use lots of it)
RBC (Red Blood Cells) - The number of Red Blood Cells in his body.  Normal is 4 - 5.5.  He has always been low, so we are happy with numbers around 2.5.  This number will go down with chemo.
WBC (White Blood Cells) - This tells us how many white blood cells he has (in thousands).  Normal is between 4.5 and 10.  We expect this to remain low, between 1.5 and 2.5 for a while.
Creatine - This is a good number to make sure the kidneys are working.  Normal range is between .5 and 1.2... If this gets higher, it means his kidneys are struggling.
Glucose - This number tells us that the pancreas is working.  Some kids struggle with diabetes as a result of the meds.  We want to see this number remain above 60 and below 150.
Lymphocytes - Non-cancerous T-Cells and B-Cells.  Normal would be around 1000, so we expect this number to be low.  This is the number of cells that will kill off bad cells like viruses.
Platelets - This is the number of platelets in the blood, which helps with clotting.  Normal is greater than 150.  We will transfuse more platelets if he gets lower than 30.
Co-Ags (PT,APTT) - These numbers tell us how fast he clots.
Bilirubin (Direct/Indirect/Total) - Bilirubin tells us how well the liver is working.  Normally, these numbers are less than 1, which is good.  However, when the liver starts to be under stress, they may go up.  Total Bilirubin is the Conjugated (Direct) + Unconjugated (Indirect).  The doctors said these numbers might come up, as his liver is trying to process all the meds we are giving him.
ALT/AST - these are liver numbers, letting us know how much stress the liver is under.  Normal range is between 10-50.