Going with the Flow

So last night we thought chemo was imminent, but we should have waited to post the ". . .finally!" part until today.  All night Brendan's urine osmolality (urine concentration) hovered just barely (.01) above the mark where he could receive his chemo treatment.  Three separate boluses (bags of fluids) were given in addition to diuretics in order to get him there.  But they were careful to watch his sodium levels (which actually were higher due to the sodium in the fluids they were giving him) and gave him much fewer fluids than usual to keep his sodium from being diluted.  So it was a fine balancing act.  Finally, at 10:30 a.m. today, they were ready to start the cisplatin.  It went in through his port in about an hour.  

  They are still doing a half dose of cisplatin and dividing it into three doses over three days.  Same with the etoposide (except it is a full dose).  Just as they were getting ready to give Brendan the etoposide, the doctors wanted to test the osmolality of the blood and urine and see if they could figure out why it took him so long to get the proper dilution.  When they checked with the head oncologist about it, he reminded them that giving the chemo is the most important thing, and the rest can be managed.  So the chemo treatment went forward (once they re-made the etoposide which only has a 12 hour expiration) while blood work and urine samples were taken.

You know it's chemo when they're wearing the blue plastic gowns and heavy duty purple gloves.

 Soon, Sarah, Hunter, and Yushi came to visit Brendan and have some fun.  (And they brought treats!)
 Settlers of Cataan was the game they chose to play today.

 Brendan won -- and wouldn't let them forget it!

 After snowing all day, the snow finally stopped late afternoon and we saw the sun peek out.

 With chemo done for the day, and Brendan's blood counts up, he was allowed to leave the unit to watch the movie being shown in the auditorium.  "Bolt" was the movie tonight.

 Of course, we had to take along the IV pole with the fluids.

 When we got back to the room Brendan was tired and starting to feel nauseous.  So we tucked him into bed and started more anti-nausea meds.  He watched some TV then fell asleep.  Fortunately, I've already found a leak in his feeding tube, so that is one small mess to clean up tonight and one  less big mess to clean up in the morning.  (We have not been impressed with the extensions they use here in the hospital.)

 All the nurses up here love Brendan's "Komfy Kozy Chemo" shirt.  It has zippers at the top and snaps on the sides so they can access his port without having to pull up his shirt.  And the snaps on the sides hold all the lines from the IV pole together.  The shirt was designed by a cancer kid who obviously knew what was needed in a shirt for chemo patients.   Thanks, Michelle, for finding this for Brendan.
The second doses of cisplatin and etoposide should be given tomorrow about noon.  We'd love to know what to expect each round, but we continually find that there is no predicting what will happen each time.  It's all about going with the flow.