Well Jacob started his Chemotherapy on December 26, 2003, this cycle required him to receive three different drugs over a three day hospital stay. This was also the day that we send Joshua home with Grandma and Nonno to Sudbury. Because of the complexity of setting up home care (Jacob requires daily injections) and getting all of the presciptions (Jacob needs an antibiotic every Friday Saturday and Sunday to prevent Pneumonia, and a variety of other drugs to help prevent ailments associated with the Chemotherapy) filled and ordered we had to stay in Ottawa until the end of his second cycle. This was also the day that we would see Jacob's port-a-cath (a site surgically placed under the skin for his central line) accessed for the first time....We place Emla cream on Jacob's site (just under his right armpit) an hour before to numb the skin and then a large needle is inserted into the site where it will remain until discharge to run fluids and his Chemotherapy for our entire hospital site. When the port is de-accessed (less scary!) Heprin is injected into the line in order to prevent clotting. The Central Line runs straight into Jacobs heart and allows a combination of drugs to be administered at one time if needed.
Jacob was discharged on December 28 and we returned to the Rotel until January 5th when we finally got word that we could have a room at the Ronald McDonald House. The Ronald McDonald house is truly a home away from home and we could finally cook ourselves a hot meal. Jacob handled the first cycle without trouble, his counts (Jacob requires his blood checked twice a week) recovered without the help of a transfusion and he did not become neutropenic (this happens when his white blood cells that fight off infections are dangerously low). We were very optimistic at this point that maybe this trend would contine throughout the treatments!
January 12...Mike and I are not ready for what we find this morning....Jacob has lost half his head of hair overnight. Over the next three or four days the rest of his hair falls out leaving him with a sparse ring of hair around the hair line. For some reason this event makes his illness very REAL now.
January 14 we report to the MDU (oncology clinic at CHEO where admissions, doctors appointments, and blood work is done) for his admission and blood work for the second cycle. Jacob's counts (blood work) have to be at a certain level in order to safely start each cycle of Chemotherapy. Because he did so well after the first round his counts were excellent and the second round was started....this round only required an overnight stay.....unfortunatley all good things come to an end and Jacob stops eating for the first time.....Mike and I are not ready for this....
January 16 we awake to get things packed to return to Sudbury and Jacob begins to vomit everywhere.....we can not get any medication into him and Mike and I look at each other with dispare as we head to the hospital for help. Jacob vomits several more times and the decision to admit him is made. Jacob receives around the clock Ondasetron (a drug to block nausea) and Gravol and stops vomiting the next day. The blood work taken that morning shows that Jacob's Hemoglobin has dropped to 78 (normal is above 110) and he will need his first blood transfusion. The transfusion takes a little over three hours and Jacob does't nap very well because of the constant monitoring of blood pressure and temperature required during the procedure. The blood really gives Jacob a lot of energy and we joke about them giving him a little too much! We are let out on pass for the weekend and re-book a flight home for Monday.
January 19-HOME finally..after 6 weeks in Ottawa we are overjoyed to be at home....our homecoming brings much joy with our reunion with Joshua, but also brings panic over the unknown with care in Sudbury.
January 20-We have our first visit to NEO (North Eastern Ontario Regional Cancer Centre) and meet the team who will be looking after Jacob while we are at home. We find the care here excellent and Joshua is especially excited as they have a waterfall with fish that he can 'feed' (he gets to throw change into the water and make a wish). Jacob's platelets start to drop below normal for the first time and Mike and I contine to wonder what lies around the corner.....
January 26-we notice massive bruising on Jacob's legs that don't seem normal and call the on-call pediatrician in Sudbury who tells us to bring Jacob into the Pediatric Unit at the Hospital. We arrive and just after his blood work is done Jacob's nose starts to bleed and we know something is wrong......his platelets come back at a 7 (normal is above 150) and two units of platelets are ordered. Jacob's port is accessed and we are admitted overnnight for the transfusion. We learn early the next morning that only one unit of platelets is available because of a shortage in Sudbury (it takes 4 units of blood to make one unit of platelets), and Jacob is sent home with his level at 23 (a transfusion is required under 20) and Mike and I are uneasy about the decision. We notice more Petechiae (tiny red dots that appear when platelets are low) on Jacob near the end of the day and make another call to the hospital and bring him back in for blood work that night. His platelet level comes back at 21 and we are told that this is safe and to keep him in a very safe environment (Mike and I look at each other and question our ability to do this since Jacob has just recently decided that he can walk on his own).
January 28-We arrive at NEO for a scheduled appointment to check Jacobs levels...Dr Murray gives Jacob a check-up and is very concerned over the blueish look to Jacobs legs and calls CHEO. CHEO is also concerned over the possibility that the cancer has spread to Jacob's skin and we are rushed to CHEO on the first flight out in the morning. Mike and I are up half the night worrying about the implications that this could have on Jacob and his chance to beat the cancer........
January 29-We arrive at CHEO at 11am and immediatly Jacob is looked at by the Oncologist and Surgeon and they feel that Jacob's brusing is probably caused by his drop in platelets and not by the spread of the disease, but want to see him again on Monday to be certain. Mike and I return to the Ronald McDonald House and we dispair about the possibility of being here again for an extended period without Joshua......
February 2-We arrive at the MDU for blood work and Jacob's bruises are now starting to slowly fade and there is no worry of the spread of the disease (Mike and I thank god for this). Jacob's counts come back low and his third cycle is pushed out until Friday........
