Setbacks Delay Chemo

January 22nd, 2007 - 11:12pm by Mom

What a day!! We brought Kevin back to Mpls Children's Hospital early this morning for what we thought would be the start of his first round of chemo. But there was yet another of life's curve balls waiting for us.

Kevin hadn't been feeling well since he was discharged last Monday. He was very short of breath with any exertion, so they wanted a chest x-ray before they started the chemo. The results showed that the left lung had many areas of infiltrate. Generally after the bloody fluid stops draining, the chest tube is removed, which was the case with Kevin last Monday. The residual thickens and clots and resolves on its own. However, because of the lung scarring that Kevin has from the radiation in 2005, his lungs aren't responding as they should, and the residual infiltrate never resolved, but increased.

After seeing the results of the chest x-ray, a CT scan was ordered. Its results were even more alarming then the x-ray had been. Dr. McNamara, a pulmonologist, 2 surgeons, and Dr. Bendel, the oncologist, were all consulting back and forth about what to do--basically 2 choices--surgery and delay chemo for 2 or more weeks, or start chemo now and see if this infiltrate will resolve in it's own. If we choose the 2nd, it could take a month or more before this infiltrate resolves, during which time Kevin would not be feeling very good--especially when you combine that with chemo.

The big risk also with this choice is if the infiltrate doesn't resolve on its own and they end up having to do surgery after Kevin has started his chemo, the risk is greatly increased since his cell counts will be down and risk of infection and bleeding that much greater. Choosing the first option--surgery now--also has risks. The surgery is extensive because they have to scrape away all of these areas of bloody, pus-like sludge to clean these sites, then will adhere the pleural cavity to the lung for a period of time--therefore eliminating this space so it doesn't become infiltrated again. There would be 2 chest tubes in after surgery for up to a week. If they can't get all of these areas clean using the scopes, they would have to make a big incision. This surgery is always risky and would delay chemo until the chest tubes are out and Kevin is partially recovered so as not to overly tax his system. None of the specialists really knew which way to go--so many pros and cons with each choice.

The surgery has been tentatively scheduled for 1:30 pm tomorrow, but they decided we would all sleep on it tonight, see how Kevin does through the night, and make a decision tomorrow morning. Kevin's hemoglobin has been low since his first surgery, so he was given a blood transfusion tonight--that should make him feel a little better. His chest is already looking like quite the road map with the surgical scars from 2005 and the recent ones from earlier this month. I really don't want to see him have to endure another extensive surgery like this one would entail. And the longer we delay chemo, the more those little beasties are proliferating and partying around--beginning to make themselves quite at home already and aren't shy about over extending their welcome! So I really hope the general consensus tomorrow is to let everything run its course and start the chemo. But that is also taking a big gamble.

Dick and I came back home late tonight, but will be going back to the hospital tomorrow. I will need to do some major adjusting for work since I had a whole day of appointments and tasks scheduled for Tuesday. Thankfully both of our employers are very understanding. Everyone pray that whatever decision is reached tomorrow, it will be the right one for Kevin.