Ethan was discharged from the hospital on Sunday, 6/9.  It was a longer hospital stay than we anticipated, but a few small issues prevented him from being discharged as planned on Friday.  The good news is that we were fortunate enough to get a day pass on Saturday so that we could bring him home for a few hours.  It was VERY nice. 

The surgery went well and Ethan is the proud owner of a Broviac-like double-lumen "tubie".  He also has a new friend, Bob, that the nurses gave him who also has a central line that Ethan can practice taking care of.  Ethan drew a big happy face on Bob (although some would argue that it looks like Bob drove over a speed bump while applying lipstick ;-) and even drew a "lumpy" on the back of his head.  Bob's lumpy is blue and Ethan was somewhat disappointed when Dr. Magram (his Neurosurgeon) told him on Friday that his lumpy was more pink than blue. 

All and all, I'd say he tolerated the initial treatment pretty well.  Here are some finer details of his treatment plan:

• Vincristine - Receives on days 1, 8 and 15.  This is an injection into his IV.
• Cisplatin - Receives on day 1 with LOTS of hydration and Mannitol (osmotic diuretic to help flush kidneys).  This is a very intense drug
  agent, which requires us to be in-patient for its administration.  Its also administered via IV and takes about 6 hours to drip.
• Etoposide (VP-16) - Receives on days 2-22.  This is an oral drug that tastes like the nastiest thing you could imagine.  We're trying lots of different "mixers" but still haven't found a silver bullet.
• Cytoxan - Receives on day 2 via IV.  The Cytoxan only takes about an hour to drip, but Mesna is given 15 minutes before the Cytoxan and at hours 3, 6, 9, and 12 afterwards to protect his bladder from bleeding and inflammation. 

The first evening of chemotherapy and the following morning were the hardest... a lot of vomiting and a bad reaction to Phenergan, one of the antimedics (anti-nausea medication).  Since then, we've been able to better control his reactions, but still have a few "sick" spells a day.  I think it will take us a while to find the right combination of antimedics that work best for him, along with the right timing to dispense each.  We used Kytril and Ativan in the hospital and are using Zofan (very much like Kytril) and Ativan at home. 

Bert & I had a steep learning curve in the hospital ourselves.  We had to learn to flush his central line with saline and heparin (twice daily), clean the surgical site and change the central line dressing (every other day for now) and to even give him granuolite colony stimulating factor (GCSF) shots to boost his immunity.  Unfortunately, the shots will be a daily routine for us for 1-2 weeks during each chemotherapy cycle.  If you can believe it, Bert and I were practicing shots on each other!!  That's love I suppose.

We're returning to the Oncologist office now for complete blood cell (CBC) count.  We'll do that two to three times every week and figure out when and for how long he needs the GCSF shots.  Wish us luck!

Regards,  Kim, Bert, Ethan and Kyra

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Revised: 06 Mar 2006 16:45:49 -0500.