Day 8 Chemo Round 4

I have no complaints about doing the chemo at home. So far so good. The coordinator has been discussing doing the Cyclophosphamide (CPM) outpatient. I'm pretty sure I am all for it. Looking back at the blog for Round 2, Asher only had ONE day of fever, and it was early in the round and it was only 38.1 and nothing came of it. Asher is due for CPM Sunday, but they aren't going to do it (outpatient or inpatient) until Monday. I guess it would be about 18 hours late. Asher will only have CPM for TWO days (Monday and Tuesday) and there is no Vincristine (VCR) this round so he would be done after Tuesday. He would need fluids and some extra care from home health for a couple of days then....he requires Mesna. Neupogen shots begin Wednesday and I have been trained on how to give the shot, but have not done it yet. He would need blood draws for counts, not sure if this is every day or every other day. Asher threw up quite often in round 2 after receiving the CPM and in the morning. If I can control it with Zofran, hopefully it would not be an issue having him home and feeling too ill. For some reason, they never (or hardly ever) gave Zofran prior to the chemo. If it is okay for me to give him some prior to the CPM, maybe he wouldn't throw up at all.

Anyway, so we probably won't even know if he will be admitted till we go to the hospital Monday at 10am because his oncologist is on vacation till then and the coordinator will not call him (if he calls in though, she will ask him about doing it outpatient).

The home nurse (a new one since we have new insurance this year) is coming in the next couple of hours to check on Asher and to see if I did the dressing change over his BROVIAC okay. She wasn't too happy that we didn't want her here to do a dressing change (well, I had already done it yesterday morning and didn't talk to her till afternoon), but I have been doing them for months, so I didn't really think much of it. Plus, I have been trained on everything at the hospital, and paperwork is in his file there, so she won't have to do that paperwork. Oh well, I should play nice, since I'll need the home nurse to come do his fluids/Mesna and help coordinate with that if we end up doing the CPM outpatient.

UPDATE 5:30pm:
Met with Dee, Asher's home nurse. She came at nap time so I kept Asher up till she got here and she was polite enough to just take a quick look at him, have me take his temperature for her and then get my signature three times and let us nap (Asher, not me, Aubree decided she didn't need an afternoon nap, ha). She said if we do the CPM at the outpatient clinic, she would come there to hook up Asher for his trip home then....thanks for reminding me Kathleen, I need to ask for IV Zofran because I know they can get it for me instead of this oral one we have. I'm not sure what the home nurse would come hook up for home...maybe just fluids? Lasix?

Hmmm...here is what 8/21 was like:

12:30-4:30pm - IV Fluids in preparation for chemo
4:30-6:30pm - Mesna
6:30-7:30pm - cyclophosphamide chemotherapy
7:30pm Asher all of a sudden had an extreme case of vomiting

So convert that for Monday 1/15:

10am-2pm: IV fluids
2pm-4pm: Mesna
3pm: Zofran by IV hopefully????
4-5pm: CPM

Clinic closes at 5pm I think....so they kick us out at 5pm then....hmmmm....sure hope he doesn't vomit in the car during the one hour trip home. Guess we'll have to see how it goes.

(A side note: we will definitely be doing round 5 and the last one with the transplant inpatient. Round 5 is like round 1 and 3 and Asher got fevers and very sick those two rounds, so we'll definitely not take a chance being home. This is one reason, since this round isn't hard, I'm trying to get more time at home with the girls. It is RSV season and they aren't allowed to visit in the hospital (and we were told that could go till April).)