OK, we got the go ahead to start chemo tonight. Oscar will have a drug called Mercaptipurine every day for the next 18 months and, once a week, another drug called Methotrexate. Oscar toleratures the first drug well but you may remember Methotrexate is the drug that gave Oscar bad mucusitis, although, of course, this is a much lower dose.
There may be an adjustment period over the next couple of months, depending on how Oscar tolerates the drugs. We will be in clinic each week to check his bloods. In some cases the bloods can crash and there may be some hospital time involved but we are expecting Oscar to cope well with the medication and make the adjustment smoothly, as he tends to do. The Dr's aim, throughout maintenance, to keep his white blood cells between 2 and 3 and to ensure he doesn't become neutropenic (neutrophils need to be above 1) and adjust the dosage whenever there is variation from these goals.
Both drugs have to be given in the evening a minimum of 1 hour away from food and particularly dairy. For Oscar this means waking him an hour or so after he has gone to sleep, getting him to take the drug and then getting him back to sleep. Its always hard doing this, especially in the first week, but it will no doubt become a habit we all surrender to each day.
Oscar is also scheduled to have his central line removed on 16th March - this will be the most exciting thing to happen to him since diagnosis. To have his freedom back to swim and play with water as every toddler loves to do will be a joyous occasion.
As always, with each new phase of treatment the key is to surrender.
Sounds simple........... but then simple can be hard to find at times. Still, a good thing to aim for.
Surrender. Just be.
Have a great weekend.