We have just completed day 22 of a 28-day induction regiment. This intense first month has thus far involved five chemotherapeutic agents, countless blood tests, 2 bone marrow biopsies and 2 spinal taps. It will culminate next week with an extravaganza of tests and procedures used to gauge initial treatment response.
But let’s not get ahead of ourselves.
Prior to receiving his day 22 infusion, Callen is thoroughly examined by his physician. In just three weeks, many of the stigmata of his treatment are manifest: clearly evident are his moon facies, his centrally-located weight gain, his dry and thinning skin. The doctor questions me about other symptoms- hunger, sleep disturbance, mood changes, pains, muscle weakness. I affirm the presence of each. The doctor comments that his hair appears to be thinning already, to which I must sheepishly confess that I cut his hair, unable to take him out for a “real” haircut (In my own defense, Julia did declare it “the best mom haircut EVER”). He is checked for signs of bleeding, bruising, lymph node swelling, organ enlargement - all thankfully absent.
The drug he receives on this day, vincristine, is not “count dependent” meaning that he will receive it irrespective of white, red and platelet counts. Its life-saving powers are withheld only if Callen’s bowel function has slowed to an unacceptable rate, as this increases the risk of a potentially life-threatening cascade of events. Having met criteria, he is good to go (pardon the pun).
The verification begins. A team of three nurses checks, double checks, triple checks. Clearance is given. And so it is hung.
For the twenty minutes it takes to run in, I try to forget what I know about this medicine. Despite its healing powers, or perhaps because of them, it carries with it bold-faced box warnings from the FDA, National Institutes of Occupational Safety and Health, World Health Organization and Institute of Safe Medical Practices, to name a few.
With great care and love for her little charge, Callen’s nurse stays by his side throughout. It is the only time in the 3.5 hour visit that he doesn’t ask for a single distraction. Netflix is turned off at his request. Every nervous behavior ceases: there is no more shifting in his seat, tapping his feet, picking at his nails, giving barely audible responses to questions while he avoids eye contact. His body language belies the events taking place. He is now relaxed and reposed, and - save the IV running into his central line - appears to be doing nothing of great significance.
The transfusion is complete. His all-encompasing smile returns. His blue eyes meet ours. He says “I love you” to the room in general.
Yes, that’s some powerful stuff!
