Methotrexate Day 3

Luke remains in residence at MDA. The chemo this time around is a blast of IV methotrexate which is nasty stuff. The kidneys do not tolerate methotrexate well and it will cause inflammation of the mucus membrane in the mouth if left in the system. The basic plan of action has been to put the methotrexate in and then flush it out as quickly as possible.

Before they started the methotrexate Luke got IV fluids to bring his kidney pH level up to minimize damage to his kidneys. Once they got the pH up the methotrexate went in over 24 hours. After that it’s been an IV fluid flush.

The methotrexate has not been kind. There’s been a lot of nausea. Luke has gotten multiple meds for nausea that has kept him knocked out. White cells and platelets are holding up, red cells are low. Expect he will be transfused in the morning.

Methotrexate concentration started above 60 and is down to 1.1 this evening. It has to be down to 0.1 before Luke can be discharged. Been told getting down to 1.0 is the easy part. Hoping to get out of here tomorrow but getting the methotrexate down to 0.1 can take a lot more time.

What a difference as 48 hours makes!  Sunday and Monday were miserable days with a headache,  and throat soars .  On Tuesday Luke finally ate and got out of bed and cruised the halls for the first time since being admitted on Sunday.  Best of all on Wednesday counts had recovered enough for Luke to be released from the care, custody and control of MD Anderson.

Blood counts improved on all fronts.  White count increased from .1 to above 2 (normal is +4).  Platelets got above 20 (normal is +140).  Hemoglobin is at 9 (normal is +14).  He is at clinic tomorrow to draw labs.  If counts continue to improve he will be inpatient for chemo Wednesday and Thursday next week.   Next week's chemo includes a high dose of methotrexate in the spine which in the past has been rough.

Beth will be in H town late next week.  Adri is coming to town next weekend.  We are  looking forward to meeting the much anticipated and world renowned beauty, Adri, from Monterrey!