Round Three of High-dose Methotrexate

Last Sunday, March 4, proved to be a very full day.  Kristen had been preparing for the California Piano Certificate of Merit exam which took place on Sunday.  The examination included sight reading, technique, performance of two pieces she had practiced, and a written theory test. As this was her first time sitting for this exam, she was very nervous.  Because of our crazy lack of schedule, she has had a hard time getting in regular practice times, but she has worked hard on all the components. I took her for the exam at 11:30 a.m. Parents were not allowed into the examination room, which added to her anxiety.  But she did just fine. We found out Tuesday at her piano lesson that she did an excellent job and passed with honors. Great work, Kristen!

Following the exam, my family had a mini family reunion with my mom, two of her brothers, and a couple of my cousins.  It was good to see them again.

Derek was also scheduled to be admitted to the hospital Sunday evening for round three of high-dose methotrexate.  I took him in at 8 p.m. and we settled in for the night after a busy day.

Monday morning he was sedated for intrathecal chemo in his spinal fluid and then was hooked up to a large bag of methotrexate which flowed slowly into his veins for 24 hours.  This time time around, I did not push fluids the first two days, as I had done before. Derek's chemo levels in his blood came down a little more slowly, and it did not qualify him for early release, which was a good thing. This meant that he got more leucovorin to put folic acid back in his healthy cells. It also meant that he was in the hospital for six days.  Once I knew he had to clear the methotrexate to 0.1 before being sent home, I started pushing him to drink more fluids.  He has gotten three small mouth sores, but they have not prevented his eating and drinking as they did before.  I am convinced now, that he needs the extra leucovorin.

When Derek saw me writing this blog entry, he wanted me to write this for him. "I just had my high-dose methotrexate. If I don't get enough leucovorin I get mouth sores."

Derek's energy level has not dropped at all.  By Friday, it was all I could do to keep him contained.  Friday afternoon, the nurse disconnected his port from the IV pole, and I took him down to a floor that has a long hallway connecting the children's hospital with the main hospital.  It has windows that look out the front of the hospital.  Because that floor is mainly used for outpatient procedures, there are very few people around in the late afternoons, evenings, and weekends.  He could run up and down the carpeted hallway to his hearts content.

Sabbath morning, Derek's methotrexate level finally reached .08 and he was released from the hospital about noon.  It was great to get home.  Friends brought lunch over, and we hiked up the hill behind our house in the afternoon.

Three rounds of high-dose methotrexate down. One more to go.  He is supposed to be home this week and go in next Monday for his last dose.  Then he moves on to Phase 4.