Still Vacationing at MD Anderson

We finally got to talk with our Oncologist today (she was out yesterday). She told us that Lauri will need to stay in the hospital through Wednesday, possibly as long as Thursday. Lauri's start date for Round 5 of chemotherapy will be pushed back about a week to allow Lauri's health to return. It's not so much that Lauri is feeling bad right now, it is more that the doctors want to give her body additional time to counteract whatever it is that put her in the hospital. No medicine can compare to the body's natural ability to fight infection, specifically those white blood cells. Stepping directly into another round of chemo will obliterate those white cells again, leaving the door open for further proliferation of infection.

The decision was made to no longer provide Lauri with any Tylenol beginning on Sunday afternoon. Tylenol would only be administered if her fever had risen above 101 deg for four hours or more. Instead, Lauri's temperature was managed with ice packs. She did have a temperature of around 102 on Sunday evening, but it has since fallen and she has had no fever since Sunday evening. She must remain without fever for at least 48 hours before our Oncologist will allow her to leave the hospital. They decided to stop providing Tylenol in order to better track the behavior and magnitude of the fever. Tylenol masks the fever, giving the doctors no insight into its actual value, and how it is effected by blood counts, antibiotic medication, etc. Relieving the fever is merely relieving a symptom of the problem, not the problem itself...

We also spoke with our Oncologist about the maximum number of chemo rounds we should expect, and what the path forward from here would be. She told us that we will complete 6 rounds (we have finished 4 to date), and then re-evaluate. At this point, she has neither ruled in nor ruled out surgery. In order for surgery to take place, our doctor must be satisfied that the disease is under control and that surgery would be able to remove 100% of the tumors. At this point, she is not sold that either criteria is met.

Her concern arises from the "stuff" that had shown up in Lauri's left lung. She is not going to proceed with surgery if the stuff remains, or grows, meaning the disease is not under control. As we saw in the previous CT scan, it looks like this "stuff" is going away, and was likely due to infection. Until it is totally gone, though, it will continue to be a roadblock. The next CT scan should provide more information on this front.

So the path forward is that we will continue with two more rounds of chemo, and then take a look at where we are. If the tumors have been controlled (no growth, perhaps shrinkage) and the stuff in the left lung is gone, then we will meet with the surgeons to determine if the remaining tumors are operable. If the tumors have not been controlled, or if the stuff in the left lung persists, then changes to the chemo dosage, drug type, and/or frequency will be made, and additional rounds will be required.

In the meantime, Lauri remains at the hospital, relaxing and trying to "be cool". Keep posting comments, she reads them all the time. Thanks for all of your support!