Thursday afternoon, Jim and I attended Julia’s high school commencement ceremony. What a beautiful sight to behold – an auditorium of young adults, full of hope and promise, brimming with enthusiasm and beaming with pride. We watched as each student crossed that stage to a soundtrack of cheers, whistles, applause and the occasional cowbell. We could not have been more proud to witness Julia receiving her diploma, her trademark sunny smile and dimple visible even from our distant vantage point. What a moment to relish! What a memory to treasure!
Friday marked a graduation of sorts for Callen, too: day 56, the final day of consolidation chemotherapy. To commemorate this, he was to have undergone a fourth bone marrow biopsy and seventh spinal tap to evaluate response to treatment. Without time to rest on his laurels, his protocol then requires immediate admission to the hospital to begin round-the-clock high dose methotrexate chemotherapy. The intensity of this next agent is such that it not only requires continuous inpatient monitoring for several days, but an antidote of sorts (called a “leukovorin rescue”) to be administered 42, 48 and 54 hours after the start of each infusion in an effort to confine the lethal effects of this drug to his cancer cells. Once begun, this cycle of interim maintenance chemo continues every other week for eight weeks.
But his little body simply isn’t ready to commence this next phase. Ravaged by the last eight weeks of chemotherapy, his red and white cell lines – and hopefully every trace of cancer in his body -have been devastated by the poisons. His ANC has fallen to zero. He remains anemic. Only his platelets have begun to rally a bit, helped along by 2 recent rounds of platelet transfusions. Until his ANC rises to 750 he is ineligible to proceed lest the cure become worse than the disease. Intellectually, I understand the need for this “chemo holiday”: the risk of infection (or worse) were they to proceed is simply too great. But emotionally, I fear what else could gain strength while Callen pauses to gather his.
And so we were ultimately sent home. But not before Callen had his third packed red cell transfusion. Followed by his first transfusion reaction. And medication to combat the reaction. Which lead to agitation and confusion. And in this induced stupor and disorientation, he soiled himself. And when the pediatric floor sent over replacement pants – cropped red sweatpants with a blue racing pinstripe – he threw a tantrum of epic proportion, his dignity having been dealt a final and devastating blow. For the ensuing hour, while the transfusion was restarted and completed without further incident, he thrashed and wailed and sobbed and railed against having to wear those red pants, and seemingly every other affront he has been asked (forced) to endure. We could do nothing more than take turns holding him – tightly enough to prevent injury at his own hands, but also gently so as not to bruise his delicate tissues by ours.
Nine hours later, exhausted, we left clinic. Callen ceremoniously ended his day in a manner befitting any recent graduate – passed out face down across the back seat of the car, naked from the waist down, those damned red pants having been shed the moment he reached the car … and with it, we can only hope and pray, any memory of this graduation day.
