Update During the 4th Round of Chemotherapy
November 8, 1999
Madison in the hospital AGAIN!
On November 6, 1999 Madisonís hemoglobin was 6.8 g/DL and required her to have a blood transfusion. On November 7, 1999 Madison spiked a temperature of 103.5 į F, requiring her to be hospitalized for a minimum of 48 hours. She should be discharged on Tuesday night (November 9, 1999).
Madison receives Fortaz and Vancomycin, two broad range antibiotics to help fight any potential bacterial based infections during these visits. It is more probable that her body is reacting to the blood transfusion rather than the start of an infection. However, blood cultures are drawn from both ports of her broviac tubes. These are reviewed at 24 hrs. and 48 hrs. after sampling to see if any bacteria based cultures grow. If these are negative than she will be allowed to go home.
Madisonís AFP numbers have decreased from 832,240 to (fluctuating from 17,990 ng/ml on 10/17/99 to 21243 ng/ml on 10/27/99). Not sure why a slight increase was noted, however, the doctors suggest that the overall trend downward is positive. The major reductions are anticipated after the tumor is surgically removed. The goal is less than 10 ng/ml.
The tumor in the right atrium (auricle) of the heart has decreased from 3.28 cm in July of 1999 to 0.954 cm as of October 8, 1999.
The mass on the liver is shrinking steadily. At initial diagnosis (July 28, 1999) the CT of the abdomen revealed a large 15 x 15 cm liver mass, mostly in the right lobe of the liver. As of the October 8, 1999 CT the maximum dimensional size of the liver mass was 4.9 cm x 6.5 cm
Lung Progress (No Change since October 16, 1999)
The lung tumors are shrinking very noticeably. Originally, it was thought that there were 6-12 tumors per lung and that lung surgery would definitely be required. After this round of chemo, it appears that some tumors on the lungs have disappeared and that this may be manageable by chemotherapy without surgery.
IVC Progress (No Change since October 16, 1999)
For the first time the IVC was identified and it appears that some blood may be making its way through the vein. See illustrated diagram of inferior vena cava in Heart Progress.
Madisonís hemoglobin dropped to 6.8. She received a blood transfusion on November 6, 1999. Approximately 150 ml of donor direct blood was given to her and her hemoglobin rose to 9.8 as of November 7, 1999.
White Blood Cell and ANC
Madisonís white blood cell count and ANC dropped to 2.9 K/cu. mm and 261, respectively, causing her to be "quarantined" or kept away from visitors. This is mainly due to her inability to fight infection. Our family has had its share of an upper respiratory viral infection, putting us all on edge trying to keep it away from Madison. Her hospital visit includes I.V. pushes of Vancomycin and Fortaz, two antibiotics that will help fight a broad range of bacterial strains. This is used as a precautionary measure to fight the onset of any infections before they start.
Madisonís platelet counts continue to fluctuate with each chemotherapy treatment. The chart below demonstrates the platelet responses to each chemo treatment.