Second verse, hopefully not the same as the first. Well, hopefully not totally the same. He had some serious ups and downs the first time but his response to the chemo was dramatic and excellent and we'll take that part again.
Phil is in the hospital again, this time voluntarily and on schedule as of yesterday morning. This is the beginning of Round B for Cycle One for the chemotherapy during which he will receive high dose methotrexate. The methotrexate is given as a lethal dose which if given alone would literally wipe out his bone marrow. That's actually kind of the point because that's where these bastard cancer cells are replicating and making trouble. However, wiping out his marrow at this point would be problematic and won't be allowed.
He will also be given a "rescue medicine " called Leucovorin which helps to clear the methotrexate from his system. Once the methotrexate levels are low enough in his blood he can come home again, probably in about 3 days. Generally, this regimen is not as difficult to tolerate as Round A.
Today is day 2 of this regimen and that means he is due for his second spinal tap. He has a great attitude and a proactive game plan to try to avoid developing a spinal headache like he did before. He will be receiving two chemo agents in his spinal tap today instead of only one, thus cutting the number of taps he will have by half. He will also lie flat for 6 hours instead of just 4. Lastly, his doctor will challenge him with a whole series of maneuvers to ensure that he has no symptoms of spinal headache prior to being discharged home. If he shows any symptoms at all he will be given a blood patch and made comfortable.
The likelihood of him developing a spinal headache again are actually fairly low and his anxiety about this happening have faded with time. Having said that, if it does happen, Phil and his doctor have discussed plan B. A small reservoir can be surgically implanted under the scalp with a catheter that delivers medication to the ventricle. We're hoping against it but glad for options.
In case you were under the impression that Phil was above reproach, let me enlighten you. Sweet Phil has gone to the dark side and resorted to performance enhancing drugs. He got some Procrit yesterday so unfortunately for him, he won't be competing in any professional cycling races for the next two years because Procrit is a trade name for epoeitin. Yes friends, our man Phil is a blood doper. Looks like he'll be serving out a ban from the sport for a while. In addition, he'll be receiving a much needed blood transfusion today as his HCT is still low and he's got the pallor to prove it.
All kidding aside, Phil's spirits are great, we just finished up an awesome visit with Tricia, my best friend from WA, and Phil was able to enjoy two get-togethers over Labor Day weekend. Having cancer isn't the sum of who he is and although he'll come home from this hospitalization and his WBC count will plummet, his energy will bottom out and he'll become dependent on all of us around him again, he's seen that he can handle it and that he does bounce back eventually.
Our life has become a roller coaster that we're all learning to ride and even occasionally throw up our hands and say "weeee" on.
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