Aiming for home

In talking with the attending physician today, I asked lots of questions to see what kind of assurance we have of going home later this week.

He told me that the biggest concern with James and the methotrexate is sores. Methotrexate damages the lining of the mouth, esophagus, stomach and intestine,causing mucousitis. It can be very painful and is treated with pain medication until it has a chance to regenerate and recover (I didn't think to ask how long that takes). Sometimes Tylenol is sufficient to manage pain, sometimes morphine is required. Methotrexate does not generally lower counts, putting one at risk for infections. So this should not keep us from going home as I first thought. The nador (or the low point after a particular chemo drug) for methotrexate occurs at about 7 to 10 for most people.

There is still some debate about whether or not James will receive his Vincristine as an outpatient or inpatient. The thought varies daily, it seems. Today's thought is that he will come in as an outpatient, but we should be prepared to check in. Just in case. Vincristine does not lower blood counts either, but, as we have seen over the past couple of months, it does tend to wreak havoc with the GI system. They are still planning on James getting his vincristine dose on Monday.

Aside from the possibility of infection (which should be relatively low right now), there isn't too much that should keep us from going home on Thursday.

Today a medical supply company rep delivered James' new feeding pump and supplies. Yesterday we got word that James MA was approved for April and May.

James' dose of methotrexate is nearly complete. Because his hemoglobin is falling, he is due to get a unit of blood once his chemo is complete. Earlier, Nan asked if a child James' age and size gets a full unit. He actually gets about 150 ccs of blood. If memory serves me from our conversation, an adult unit is about 325 ccs.

Please pray:

1. that James will not react to the blood he gets tonight.
2. that his body will clear out the methotrexate to safe levels quickly (that is another thing that could delay our discharge).
3. that the Lord would continue to protect James from infection.

Thanks for stopping by.

Love, Stephanie