Day -15: First Day of the Last Treatment!

Welcome to a blog about Dad's high-dose chemotherapy experience! Dad (better known to many of you as "Rod") and I (Eva!) decided to start this blog so that everyone can easily keep up with him over the next several weeks. Of course we still welcome your calls, emails, and other forms of communication!

Melissa, Dad, and I in the BMTU

To briefly catch everyone up, Dad was diagnosed with non-Hodgkin's lymphoma back in February 2010. He underwent R-CHOP treatment and head/neck radiation. His lymphoma went into remission for a short time, but unfortunately it recurred in February 2011.

Dad then was given R-ICE treatment in Huntsville with Dr. Gualtieri, in preparation for bone marrow transplant and high dose chemotherapy. We decided to go to UAB for the transplant and high dose therapy, as they have been doing it for a long time. Also, our UAB oncologist, Dr. Vaughan, was one of the original developers of the current high-dose treatment regimen! Every time we see him he tries to convince me to go into oncology...

Dad underwent "mobilization" chemo and stem cell collection in June 2011. Then he was able to rest and grow strong again for a month at Amanda and Alex's house. Today we're back for the hardest part!

We arrived at the Bone Marrow Transplant Unit (BMTU) on the 3rd floor of UAB Hospital around 11am. Dad's vital signs were taken and he was weighed--we're happy to report that Dad weighed-in at a healthy 147.8lbs (67.2kgs) (up from his last hospital weight of 132lbs)! Thanks for all the good cooking Amanda!

Then Dad's nurse practitioner, Melissa (see photo) reviewed all of his test results with us. Everything looked great! There was still some uptake in his left deltoid (shoulder) on the MRI, but his PET scan was clean. Next we signed consent forms for the treatment. Dad will be participating in a study, but no worries, it is not a scary-orphan-drug type of study. The purpose of the study is just to get FDA approval for the treatment regimen that is already the standard of care for recurrent non-Hodgkin's lymphoma. They have been using this regimen for more than 15 years, and it has a great track record. The drugs Dad will be getting include Busulfan, Etoposide, and Cytoxan.

Dad chowing down on some BBQ

At this point, Dr. Vaughan and Melissa had to go over the possible side effects of the drugs that Dad will be getting. I have to admit, it was a gloomy discussion. Briefly, Busulfan can cause seizures (so Dad will be on Ativan for seizure prevention); Etoposide can cause sudden drops in blood pressure, fever, and malaise; Cytoxan can cause hemorrhagic cystitis (Dad will be given a lot of fluids as well as Mesna to prevent this) and SIADH. And of course it is very common to have nausea and diarrhea during the treatment. Eventually Dad will lose much of his mucosa, and so he will be pre-medicated with a drug called Palifermen to help salvage some of it.

Dad handled hearing the description of all the side effects stoically. Then we were sent down to Hospital Dentistry to get the tooth ache he's been having checked out. They attributed the ache to Dad grinding his teeth (no infection, whew), and took measurements to make a mouth guard for him. It's amazing how quickly one can get stuff like that done in the hospital! Finally, we came back upstairs to the BMTU for Dad's first Palifermen treatment, which he got around 7pm. Needless to say, it was a long first day!

After leaving the BMTU, we went to Jim and Nick's BBQ and had a large hearty meal before retiring to Hope Lodge (patient housing) for the night. Dad isn't allowed to eat anything after midnight because he will be getting two central lines placed tomorrow.

That's all for now. We will try to post updates to this blog everyday! Good night!