March 30 @11 am Dr. Madhuri Vusirikal visited with 4 doctors and 2 nurses. She was with us for about an hr and took all the time to answer all our questions. We were impressed and felt confident that we can beat this.
Rachana has B Type ALL but is negative for Philadelphia chromosome and that means we can start her on the CALGB treatment plan. The first 4 weeks will be a intense chemo called the induction phase. They expect to kill all cancer cells in these 4 weeks and they have a 85% success rate on this. After the induction phase, we have a long 2-3 year maintenance phase which is mostly outpatient but some hospital visits.
The next 4 weeks will be tough. She will be primarily on 4 drugs (Prednisone, Vincristine, Adriamycin and Pegaspargase). Dr. Vusirikala spent about 10-15 mins on side effects impacting liver, pancreas, clots, sugar levels, blood pressure, heart, vision, constipation, nausea, tingling feeling – basically she will be generally weak, tired and some important organs weakened. But most of these are short term effects and they will give other drugs to counter these side effects as they appear. She will have hair loss in 2-3 week. The Dr. said she can get wigs for free from any place – I need to check on this.
So they know all details to start the treatment, but the bone marrow results are not in yet and those can give more details that can help make the prognosis more precise. So this might happen in a few days.
When I asked about bone marrow transplant, the Dr said in a few days they will schedule the spinal tab to test the spinal fluid. This will tell them if a bone marrow transplant is needed. She asked to have her siblings do a HAL testing to make sure they are a match. If they aren’t a match or not available then we can go to the bone marrow registry to find a match. But this might not be needed – the spinal tap will confirm.
The Chemo will start tonight. Most drugs will be administered through the ports in her chest and arm – so no extra poking but 2-3 times a week they will have to draw blood from the arm manually for a few checks.
The Dr. assured us that this is a curable disease but a long journey. Rachana was mostly positive but cried asking if kids can come to meet her. They have a policy to not allow any access to kids under 12 and any adult is even slightly sick. Basically everyone on this floor of the hospital have a very weal immune system. The Dr. said she will check and a few mins later we got confirmation that the kids can come to meet us today and every Sunday for an hr. We just have to be really really careful to keep them away if they are even slightly sick. They will set up a ‘family room’ for us and she can meet the kids for 30-40 mins.
So lots of details, lots of things to be prepared for but for Rachana the biggest news was that she can meet the kids today 🙂