#5 of 5- IM

Today was Presley's final treatment for IM-1 (interim Maintenance 1), I was secretly hoping that Presley wouldn't make counts. Presley has had the Rhino virus aka. common childhood cold  all week. Mommy doesn't like the idea of Presley being sick with a stuffy nose and then getting chemo on top of it. Well her ANC count came back at 4200. Presley's ANC is always high, she amazes me. I asked the doctor today if that was a good/bad sign that her ANC is usually around the 2000 range. The doctor said it's usually not an indication of much going on. During maintenance they will most likely have to give her higher doses of 6MP (nightly oral chemo) that will keep her ANC around 750-1500. They want a suppressed immune system during maintenance. Sometimes I feel the doctors have a tendency to not give too many details. So back to the infusion room we went, waited for chemo and then we were able go home. Today's clinic was not too long just 2 hours. Today was her last dose of chemo for this round. This means in about two and 1/2 weeks she will start DI (Delayed Intensification) which is supposed to be pretty miserable, especially the second half. Today, they gave her a higher dose of Methotrexate (180mg). For some kids the Methotrexate really makes them drop their ANC and or white blood count. 
Presley was a little nervous for port access today because of the ER experience. We are so thankful for familiar faces and nurses today to calm those nerves. I promised her a trip to the Disney store if she was brave today. I'm going broke from all the bribing that I have to do!
We met a new doctor today named Dr. Barnette. During this phase since it is every 10 days our clinic day does not always fall on Wed. So we get the doctor who is at clinic that day. It has been fun to meet all the doctors in the practice.

Port is accessed waiting to see if I made counts! Happy girl always smiling!

 I participated in a study and was given a gift card. Paul gave them a clue to where I like to shop!

Playing with Doc. Barnette

Return Appointment Slip..we had a lot to do next clinic day... EKG, LP, chemo etc...

Waiting for my chemo..thank heavens for mini ipads!

Mommy and Presley. My little hero. Presley always has such a good attitude and continues
to smile through it all. You are a true hero.

We got to facetime with daddy and Crew while waiting for chemo.

Here's the goods. 

Presley loves to help Kristen push the meds into her port.

HAPPY GIRL...so glad port access was easy this time. She  came out smiling! Thanks Kristen and all the clinic nurses are the best of the best!

I Love the detail of the hospital bracelet on the foot while riding the Strider. Seems like those two shouldn't belong together but they do on this little cutie!

Round 1-  60mg 
Presley did great this round nauseous for a few days and avoid eating for a few days

Round 2-  90mg
Presley threw up twice the first night and was nauseous for a few days after and lack of appetite for a few days following. 

Round 3- 120mg 
Presley was nauseous for a few days and lack of appetite 

Round 4- 150mg 
Presley threw up twice on the ride home, was nauseous  for about a week and at the 7 days mark after chemo she developed 2 mouth sores. 

Round 5- 180 mg  

For this phase (50 days long) each round was count dependent. She made counts each round. Presley has felt pretty good. Besides the Rhino virus, having a cold and at round 5 developed a few mouth sores, Presley has done really good. Hoping this round will go the same.

Presley joined the mouth sores club last week, not a club you ever want to be in. We will try to keep cold Popsicle and ice cream down her. Less blood to the mouth means less mouth sores. Sometimes the mouth sores show up days after chemo or at the 7 days after.  
Doctor Fluchel was right on when he predicted how Presley would handle this phase. He said she would do great the first 3 or 4 rounds and only develop a few mouth sores toward the end of this phase.