Yesterday was day 8 of the induction process and it was also chemo day for Kurt. Thankfully, it was also the beginning of a 7 day break from steroids! In Leukemia treatment, steroids count as chemo too, but every couple of days he receives one or more of the "powerful" meds. Yesterday, Kurt received a dose of Methotrexate directly into his spine (he gets three of these treatments to protect his CNS during induction--one more to go!). He was also given vincristine and daunorubicin via his PICC line. Kurt did great during the administration of these medications and continues to prove that he really is Superman.
When the oncologists do the spinal injection of Methotrexate, they first take out some spinal fluid to be tested before injecting the medication. The results from Kurt's first spinal fluid tests were negative for any cancer cells in the CNS. This is great news! We pray that this proactive treatment will continue to protect those areas of the body. They left the tubes of spinal fluid on the computer desk to be picked up, so I had to snap a picture. His spinal fluid looked beautiful and crystal clear to me!
When Kurt was admitted, his blast cell count in his blood (the bad cells that shouldn't be there) was around 16,000. After 8 days of treatment, his blast cells were 10. Not 10,000---10! It is wonderful to see that the chemo is working and working quickly. The best way to really see what is happening with Leukemia cells is a bone marrow biopsy. Kurt will have another biopsy to determine remission on day 29. Measuring the blast cells in the blood does let us know chemo is working well and that there should also be a dramatic decrease in those cells in the marrow too. When Kurt has the biopsy on day 29, they will do MRD (Minimal Residual Disease) Testing on the bone marrow. This can measure how many cancer cells are in the marrow (1 out of 10,000--1 out of 100,000--1 out of 1,000,000). We are praying for no evidence of disease!
As his blast cell counts fall, so does his WBC. In a healthy person your WBC usually ranges from 4,000-10,000. If you are sick with an illness, your WBC rises. With Kurt's type of ALL, his WBC rose dramatically upon diagnosis. I think the highest count we saw before they started to drop was around 25,000. Some ALL patients are admitted with WBC's in the 100,000+ ranges. We are thankful his never got to that level. Even though he had a lot of WBCs, the ones his body was making were broken or immature. They were crowding out the healthy cells and making his RBCs low. Yesterday, Kurt's WBC was 1,000. This number will fall to zero over the next couple of days as the chemo impedes cell growth/kills cells. This is the time he is most vulnerable to infections and this is one of the reasons why he is hospitalized and watched so carefully during induction. He takes a lot of prophylactic medications to prevent infections too. He has also had two blood transfusions and probably has more to come to keep his RBC levels up.
Kurt's next big chemo day will be on day 15. He will receive the vincristine and daunorubicin again, along with restarting the steroid (Dexamethasone) for another 7 day period. So far, he is feeling really well. There has been some fatigue and a bit of nausea this morning, but he's doing great overall.
Looking out from the 11th floor has me feeling a bit like Rapunzel in her tower. Our family loves Disney's Rapunzel (Frying Pans, who knew?) and I keep thinking about her song at the very beginning of the film. She recounts all the things she does all day to keep busy. Who knows what skills Kurt and I may develop while we are here? Kurt's working on learning some tunes on his new Melodica and I have some hand-lettering supplies and some embroidery that I never seem to have time to work on at home. We have Bible studies, books, games...and yet our hearts long to be home. One thing chronic illness and now a journey with Leukemia has taught me is to cherish the ordinary days. Gifts from God we often take for granted are found in the simple daily tasks of an ordinary life. When I was younger, I was sure that I was destined for something great, something big, something people would notice. As I grew older and a little bit wiser, I realized that the greatest joys are in those normal moments of every day life--the joy of serving and not being noticed, in the quiet ways days easily flow into one another. These chaotic and strange days make me long for home---and not just my earthy home. I long for a home where the peace that floods those simple days will reign always. I have faith that God will rescue us from this "tower" and that we'll have some of those peaceful days again. I also have great joy and comfort in knowing that even if those days don't come again on this side of Heaven, I'll find them again there and they will never pass away.
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