Sunday, April 10, 2016

Induction Road Map

Unlike other cancers, there are no "stages" with Leukemia. But there are risk factors, low, standard and high risk. Ellie is currently considered standard risk. (As test results come back from her bone marrow and spinal fluid, this could change, but is unlikely.) These things work very much in our favor because it means that her course of treatment is known and proven to be effective. ALL has extremely high success rates (somewhere around 90%, I believe), but that is not too concerning to us because we are believing in her complete and permanent healing.

We strongly feel that with faith, prayer and this course of treatment, not only will Ellie be healed, but she will thrive and be a testament to our Heavenly Father's love. 

Here is what Ellie's treatment looks like for the first month, or the Induction phase...

Diagnosis: Pre B Cell Acute Lymphoblastic Leukemia
Treatment Protocol Drugs: Cytarabine, Vincristine, Dexamethasone, Pegaspargase, Methotrexate

Day 0: Cytarabine via lumbar puncture into spinal fluid
Day 1: Vincristine via IV port
Day 4: Pegaspargase via IV port
Day 8: Vincristine via IV port and Methotrexate via lumbar puncture
Day 15: Vincristine via IV port
Day 22: Vincristine via IV port
Day 29: Methotrexate via lumbar puncture
Days 1-28: Dexamethasone (steroid) given orally

After this phase is complete, it is hoped that Ellie will be in complete remission from the leukemia. From that point forward, all of her treatments are to make sure that the leukemia does not return. If it all goes as it should, the entire process will be about 2 years and 3 months. For the first 5 months, Ellie will visit the hospital weekly as an outpatient to receive her chemotherapy. Once the 5 months are up, she will then switch to once a month treatments at the hospital. Throughout this entire process, she will also receive various medications at home, including an oral chemo drug and steroids.

The port that she received will stay in her body the entire duration of the treatment. It will be used to administer drugs as well as draw blood. When it is not being accessed, it looks just like her normal skin, with a large bump underneath. There is nothing protruding from her skin. When it needs to be used, a needle will be pushed through her numbed skin and into the port, thus accessing the tube inside her vein.

Ellie has been feeling better today. Her doctor and nurse practitioner that saw her today commented on well she looked, especially from yesterday. Dr. Mogul remarked that "she is exactly how we want a patient to look on day 5." She is still not acting quite like herself, but so far she is remarkably better from the two previous evenings. Ellie still has a lot of pain, specifically in her mouth (jaw pain, a side effect of the Vincristine), stomach (constipation from everything), and her legs (general leukemia side effect). She has not walked in almost two weeks due to the pain. We have tried to make her sit up unassisted in order to engage her core and legs. We have also tried to make her stand, but that was too painful for her, so it will be something that we will have to work towards.

Right now, we are scheduled to leave the hospital on Wednesday or Thursday. But, if Ellie does not reach certain mobility milestones, then her stay will likely be extended.

Please pray that she begins to respond positively to the steroids. She needs to regain her strength and her appetite needs to return.

Pray that her constipation goes away and does not return, as it causes her a lot of pain.

Pray for Ellie's complete and permanent healing.

No comments:

Post a Comment