Round 3, Here We Go

Brendan enjoyed a leisurely morning -- sleeping in, playing, and enjoying his last moments at home.  He played while Shaun and I packed up bags and loaded the car. 

 Brendan gained another pound this week!

 Before we knew it, it was time to get on the road.  We were glad for good weather and clear roads.

 We arrived at Primary Children's Hospital audiology department right at 1 p.m.

 Brendan got the full range of hearing tests today.

 The soundproof booth is a weird kind of quiet.  Our ears are not used to that much quiet.

These are the results of Brendan's hearing test.  We saw another drop in hearing function in the higher ranges, as well as hearing loss moving down into normal hearing ranges.     

Once the audiology reports were scanned in and accessed by the oncology doctors, discussion began about the ototoxicity of the cisplatin-- (side effect of cisplatin causing ringing in the ears (tinnitus) and/or hearing loss in the upper ranges).  Protocol for cisplatin ototoxicity is that once hearing loss moves down in the 3000 hertz range, then cisplatin doses are cut in half.  If hearing loss moves in the 2000 hertz range, then cisplatin is stopped and another chemo regimen will be used.  Today we hit he 3000 hertz range, so Brendan's cisplatin dose was dropped from 100 ml to 50 ml.  In addition, those 50 ml will be given over 3 days, instead of the single dose he was given the last 2 rounds of chemo.  Hearing tests will be done again within the month, and his hearing will be monitored very closely.

After the audiology exam, we checked into the hospital and were assigned a room.  First order of business -- access his port.

 Second order of business was to get his 6 hours of fluids going.  First it was fluids with no magnesium, then orders were changed to add magnesium.  Nurses here are kept on their toes as the doctors orders keep changing based on what they are seeing.

At 9 p.m. the cisplatin was administered over a one hour period.  (That seems fast after previous administrations took 6 hours.)  At 10 p.m. the etoposide was started.  Drops in blood pressure are a concern so they nurse will be in often to take Brendan's blood pressure.  If it does drop, they will just administer the etoposide over a 2 hour period and give him more fluids.

Gown the nurses wear when handling the chemo drugs.

 Overnight anti-nausea meds were started just before the chemo, so Brendan began to be pretty tired and fell asleep quickly.

 Brendan will have to go to the bathroom at least every 2 hours so we will be waking him up all night.

That means I'll be up every two hours all night as well.  (Brendan prefers I help him with that item of business instead of the nurses :)

I want to give a big "thank you" to Megan and the staff at Dr. Firth's office for helping me take care of the insurance questions.  The hospital admissions didn't bat an eye when I told them what you told me.  That was such a huge help to me this morning!  You're the best!