Today marks another milestone: God willing, this is the last day of the LAST chemo! So far, the Gravol, Zofran and Ativan have done a good job of managing the nausea - but it is making him sleepy. And today, the final dose will be a monster-size infusion of Etoposide. To help counteract that, they will add Dexamethasone and Benadryl to the mix.... which will likely make him even sleepier.
So far, the ice chips and Chlorhexidine Gluconate rinse have done a good job of keeping mouth sores at bay, but it's early days yet. There are signs that a couple of sores are brewing, but nothing out of control at this point. Hopefully, Tom can avoid feeling as bad as his little buddy Reyce (please add your prayers to ours that he feels better soon!), as he is fighting really bad sores from his mouth right through his entire digestive tract. They are so severe he has been hospitalized. This is not the first time he's had really bad sores, and he also suffered from a bad case of shingles last month - please, God, let Reyce catch some breaks!
Yesterday the nutrionist stopped in, and we were really impressed by her. Instead of taking the traditional "Canada Food Guide" approach, she has adapted to the real world of chemo patients. She didn't mind most of our Meatarian's food habits, because she was pleased he's been getting as much nutrition as he has.
We've been forewarned that when Tom's counts really tank in about 7 days, his appetite will quite likely be non-existent. There is a strong likelihood that he'll have to be on TPN (Total Parenteral Nutrition) or NG (nasogastric) tube feeding. TPN is a way of administring essential nutrition in liquid form intravenously; NG tube feeding involves putting a tube down through the nose, past the throat and into the stomach. Neither sound like a lot of fun, but if that's what's necessary to ensure he gets nutrition at some point, so be it. They also told us that teenagers' appetites often take longer to come back after transplant than younger childrens'. So far though, Thomas is a star. His counts are still holding up really well, and tests show his kidney and bladder are functioning efficiently.
Once he starts eating again, and until 3 months post-transplant, there are a whole host of food preparation/handling precautions we will have to take. Bizarrely, bottled, canned, packaged foods or foods cooked at higher temps are safer than fresh foods - for example, a Sara Lee packaged cake is safer than fresh Timbits, Kraft Caesar salad dressing is better than homemade, processed cheese is better than fresh sliced cheddar, and a cheeseburger from any fast food chain is better for him than a Subway sandwich. But there are drawbacks: he has to order a cheeseburger with no condiments, no onions, no lettuce, tomato or special sauce - because these add-ons are at risk for contamination. The rest of us aren't at risk, but transplant patients haven't got the same immunity as we do, so that's why we'll need to take some extra precautions for Tom.
The guys chilled here at the hospital yesterday, and I helped Laura shop for a dress to wear to her convocation next month. It rained all day, and by evening the rain turned to snow. This morning there are still wisps of white laying on the ground, and the mountains are whiter than they were a few days ago. Ah, springtime in the mountains! Last week we were putting sunscreen on, and this week we are wondering if we should have brought our winter coats!
We're hoping the weather smartens up as Laura has to drive home soon to return to work, and Jeanine and Nancy are on their way today.
We are praying that Tom keeps on handling the chemo as well as he has to this point. Thanks again, for everyone's love and support! We know that your prayers and positive thoughts have made, and continue to make, a big difference.
TTYL,
Thomas' Mom
