.... and so it begins.

So the time I have been dreading is here, and I must admit - so far so good!  Aly was at the Cancer clinic on Friday to begin her next phase of treatment called delayed intensification (sounds horrible). She underwent another spinal tap, and received two additional types of chemo - vincristine ( which she has had before) and doxorubicin ( aka `the red devil). (http://en.wikipedia.org/wiki/Doxorubicin).   This drug has a number of serious side effects, like hair loss, vomiting, heart arrhythmia ( long term heart complications too), and decreased white blood cells ( will make her neutropenic which means she will have a compromised immune system).  We have been told that her white blood cells will begin to decrease around 7-10 days after treatment, and since she will be receiving this drug on an on-going basis for the next few month we need to prepare and ensure that Aly is not exposed to any germs or viruses.  Some of you might know that we have ( or are in the process) of removing all of the carpets from our house and putting down laminate flooring and we have also purchased an air purifier with a UV light to assist in reducing the number of airborne viruses in our home.  We also be limiting the number of visitors that will be coming into our home over the next few months.  I have spoken to a few families that have gone through this phase of treatment and it seems that everyone deals with it differently.  Some have continued with life as usual, others have stopped all visitors to the house ( including family members) and others have just been sure to wash hands thoroughly and limit exposure to small children or adults that are sick.  I feel we will be doing a bit of a combination of this.  Some immediate things we have already started such as, no more lip kisses with Aly - all kisses must be on her cheek, head etc., hand sanitizer can be found throughout out home, and we are also ensuring that hands are being washed ALOT.  We also plan to continue our long walks at local conservation areas - the fresh air seems to be good for her and the exercise will also be good for all of us.
  The other part of this phase of treatment that I have not been looking forward to is having to give Aly steroids again.  She is wiser now, and giving her meds has become a challenge and I need to get REALLY creative on how I administer these to her.  Currently she has to take an antibiotic that is in pill form, a liquid form of steroids and a liquid anti-nausea med when needed.  The pill is a really hard one.  So far the only thing that has been successful is by grinding it up into a powder and mixing it with honey.  She fights me, but she seems to like the sweetness of the honey.  As for the anti-nausea meds, I had success this morning by putting it in her shreddies and milk.  Once the milk was absorbed into the cereal she didn`t seem to even notice.  Now the steroids are a whole different story - I can`t risk putting them into a drink or food in case she refuses to eat or drink what I give her.  We are only given the exact amount of dexamethazone that is needed so unfortunately I have to give it to her orally via a syringe ( with no sharp of course).  She hates it and it is a big fight each time.  We try to tell her that it`s her important medicine, but she wants nothing to do with it.  It is times like this that I hope her appetite increases again and I can begin to put it back into her milk - - that is how we got this through this the first time she was on steroids. I am not sure what impact the steroids will have on her appetite this time -- but we did notice that she ate alot tonight at dinner.  She had a lot of roast beef, then wanted ice cream, then picked up another piece of beef while she finished up her ice cream, then finished it all off with a pear.  I think I might begin to document what she eats this time.
  Anyway, I guess what I am trying to say is that so far, so good.  Her morale seems to be good, she is still a lovely sweet little girl and I am hoping the shorter period of being on steroids will not impact her mood as much as it did the first time.....fingers crossed.  We are back to the clinic tomorrow for more chemo then have a break for a few days before returning on Friday.  After that, we should be back to weekly visits on Fridays.