ANC, LFT, and DOG

Yesterday was the kind of day that just doesn't know when to call it quits. Much like a guest at a party who is still downstairs drinking when the hosts have long since gone to bed.

(Don't be that guy.)

We left the house at 7:30 for our 8:30 ultrasound appointment. The oncologists wanted to see how the tumors are shrinking. I agreed to let Eve out of the stroller for the first time to play in the waiting area, and as a girl the same size came over to play next to her, all of a sudden it struck me how sad it is that she hasn't played with anyone besides her siblings in a month. The only kids she sees nowadays look a lot like her- balding, faces hidden behind masks.

(I can now understand why people go ahead and shave their heads once they start losing their hair. You have two choices: cut it all off, or find it in your food. I could have sworn I had a bug up my nose the other day, only to find one of Eve's hairs had made its way up there. And starting the day off hacking up a hairball will NOT land you on People's Sexiest list of 2009.)

We were taken back for our ultrasound, and once again, Eve was excellent. Her cooperation really amazes me and everyone who sees her at Duke. Can you picture your two-year-old being patient for not one, not two, but a two and a half hour ultrasound experience? The poor sonographer kept leaving to show the radiologist the images, and he kept asking for more. It felt a little like the man behind the curtain in the Emerald City.

It takes a few days for radiology to write up a full report, so we won't know anything until next week. But, for what it's worth, Eve's oncologist said he could barely feel the tumor and could now feel her liver, which is what her pediatrician was trying to feel when he came upon the mass.

Eve didn't even flinch when the nurse accessed her port. She just says "okay" to anything anyone dressed in scrubs or a lab coat asks her. Whatev!

Her ANC was 1330, up from 891 on Tuesday. The hospital staff speaks in abbreviations and acronyms whenever possible. Before Eve's very first chemo, I heard the doctor say, "I want a repeat LFT and ANC before chemo and then we can do the DOG."

Umm, doc, what's an ANC?
"Oh, that's the absolute neutrophil count."
Ok, then what's an LFT?
"That is a liver function test."
Then, what is a DOG?
Silence.

After deciding my second and third heads were a figment of her imagination, "You know, like ruff ruff?"

Yeah, there was an actual dog who was in the hospital to walk around and cheer up kids. I guess they didn't want to say the word in front of me in case I got too excited.

Eve's energy level has been good and she even gained a little weight since her visit last week. However, she has been hoarse since Monday. Vincristine can cause paralysis of the vocal chords and can slow down your body's reflexes. This explains why Eve has also been choking on her drinks- her airway is slow to close, so liquids really are going down the wrong way. The doctors decided to skip the Vincristine this week and pick it up at a half-dose next week, provided her hoarseness is gone. Better to skip it than to shower her lungs with apple juice.

Yesterday she received Dactinomycin and Doxorubicin. These are the ones that will drop Eve's blood counts again in a week or so. They also cause nausea, so we are pumping her full of Zofran to make it through the weekend without getting sick. She woke up this morning looking a little nauseated, but by mid-morning had requested and eaten a hot dog, pot roast and carrots, and a granola bar. We are being strict with the Zofran, because at least two of those foods you do not want to see or smell making an encore.

4 down, 2 to go!