Let the Trial Begin

I promised a more detailed update last night on Facebook, but I had to wait until after “Dancing with the Stars” and “Castle”. One must keep his priorities straight.

Everything starts on Thursday beginning at 8:30 AM with another blood draw and a consultation with our coordinator, Blanche. This will be followed by a series of ECGs spaced exactly two hours apart. Sometime during this time, I will be admitted to the Leukemia Section and begin hydration.

Friday begins with a low fat breakfast at 7:30 and the administration of the first dose of ABT-199 (20 mg) at 8:00 A.M. Blood draws will be taken every two hours throughout the evening to check for Tumor Lysis Syndrome (TLS). I have been placed in the critical category which demands extra care. The reason for this is that my CT scan showed significant increase in size of the internal node masses. The largest is over 10cm up from 8cm. All others have increased as well. Anything over 8 cm indicates a serious possibility of TLS.

TLS is the term used to indicate extremely rapid tumor death and destruction. This results in an overload on the body’s filtration system, kidneys and liver. If these two cannot handle the overload, the poisons released by cell death built up and can cause death. I’m more than happy to donate vials of blood to monitor this. As I’ve mentioned before, two people died in the first attempt at this trial.

We talked yesterday with a “fellow”, a “student” doctor involved with this trial. He happened to be at the Royal Melbourne Hospital in Australia where those two died. These patients were given the max dose immediately without buildup and monitoring. He told us the white cell count dropped from normal to 1 in eight hours!

Dr. Wierda, the lead physician for this trial, already has two people on this regimen, one of them on the critical list, with no problems. This is why we came to MD Anderson. They have a well-developed program with the safety of the patient at the center. Very little has changed in their protocol from the first attempt.

If all goes well, on Saturday or Sunday the dose will be increased to 50mg. Each subsequent week dosage will be doubled until the max of 400mg is reached. Each increase involves a short stay in the hospital. If I handle the 400 dose safely, visits will be reduced to once monthly. WE CAN GO HOME!!!!!!! Returning monthly is much preferable over staying in Houston all the time.

Don’t misunderstand, Houstonites. You have a wonderful city which I hope to explore a bit with my camera. However, Houston is not Hot Springs. The suite at MainStay Suites is nice, but it is not our home. The bed is nice and firm, but it is not my Select Comfort bed. My back aches by early morning every day, though I was informed yesterday by our Australian doctor that the size of nodes in my abdomen have been known to cause backaches. Hallelujah! Maybe I will not have them after a week or two.

That is a rather longer explanation than I originally intended, so I had best quit before I bore you all to death.

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