High Dose Chemotherapy…DONE!

As the title suggests, the last part of Zach’s in-patient treatment is complete YYYYYEEEEEESSSSSSSS!!! It didn’t go entirely without hindrance; on the last day that Zach received chemotherapy he developed a nasty infection in the vicinity of hisHickman line. Normally this would mean that his line would be removed fairly swiftly and he would be put on a course of antibiotics to treat the infection, however nothing is ever that simple with Zach. He needed to have his stem cells implanted on the second day after his last dose of chemo also known as day “0”. This meant that they had to leave his line in place so it be used on day “0” and run the risk of the infection colonising the line. The implications of this are quite severe. A Hickman line is tunnelled under the skin, up one side of the chest and passes into one of the major veins in the neck. The ends of the line sit just above the heart. As you can imagine if the line gets infected it can pass easily to the heart!!! It doesn’t end there either. While all this was going, Zach’s bowels were trying to set new speed records and the results was his potassium levels had started to drop dangerously low. Potassium plays a part in the way electrical signals pass through the heart and if they drop too low you can run into serious difficulties. Zach came to the point where if his potassium levels had dropped any more he would have to transferred to the high dependency unit. Well within a few hours the drugs started to work and disaster was avoided. 

The Stem Cells have arrived



Stem cells thawing

Day “0” arrived and we were blue lighted to Birmingham Children’s Hospital so Zach’s stem cells could be implanted. It is a straight forward procedure. The stem cells arrive in a vat of liquid nitrogen, they are defrosted in a water bath which takes about 5 min,  they are drawn up into a syringe and delivered through his Hickman line over a space of 4 mins which is timed. This was repeated again as Zach had two batches of cells. The preservative the cells are kept in can cause nausea and poor Zach was retching and vomiting for the entire 8 minutes of his cell implant. Another side effect of the preservative is it gives off a smell of tinned sweet corn when it is being excreted through the skin. So for 4 days, Zach’s isolation room smelt like a tin of green giant. The stem cells help the bone marrow recover after high dose treatment, and by day 12 the only support that Zach needed was platelet transfusion, which are still ongoing, as these are the last to recover. He will need transfusions of blood and platelets for up to six months. Zach will have further treatment for his tumours but this will be done through day care. He will be having more intrathecal chemotherapy and a course of retinoic acid, which causes cancer cells to differentiate or mature. A cancer cell is immature i.e. it is not an eye cell or a brain cell. This course of acid should force any remaining cancer cells to change and no longer be a threat. It is used in a wide range of cancers and there is good evidence to support it. This is administered orally so we can give it to him at home. Again it comes with side effects. It can cause the skin to become dry and the lips and mouth in particular. Regular vitamin E cream does help to reduce these.

We are now at home enjoying the nice weather we have been having. Looking back at the journey we have been on it hardly seems real now to look at Zach playing. He is a little behind in his development but this is understandable considering where he has come from. We have been through the extreme highs and lows of paediatric oncology and unfortunately some of the kids we have met along the way are no longer with us, but the outlook for Zach is much better. It was hard to be overtly positive about the future, but now we are looking forward to a typical British summer with some days away, the occasional barbeque and dodging the rain. For some this is something to whinge about, but for us it is a dream come true.

 

On the fundraising front it has be a feast of accomplishment. “Nae farrer” Zach’s Granda (Graham) managed to set a new and first pb at the Baker Hughes 10k in Aberdeen by completing the course in under an hour in 59mins 24 secs. His granny (Margaret) and great Aunt (Carol) also completed the course in 58 mins 31secs and 1hr 7 mins respectively so well done to all. 5 (AC) Sqn have continued their summer of sport. Personnel who are currently deployed managed to complete the journey back to the UK in the Gym. A distance of over 7500kms in 49 days. Thanks to all those who took part in this epic show of physical prowess! Kaf Whiteman tackled the tour of the Midlands ,cycling his Raleigh chopper from Skegness to Nottingham, a distance of 98 miles in a respectable 10hrs. 2hrs of this were stops ,so taking that into account along with a couple of wrong turns and he had to replace the card board that was wedged in his brake callipers, giving it that distinct motorbike sound so he did very well indeed, Thanks kaf.  There is a further programme of events to come so watch this space.