We headed into Boston around 10:30 Monday morning for Seth's weekly appointment and his Vincristine. Vitals and labs were done quickly and a dressing change because it was starting to lift. We met with the doctors and Seth's hemoglobin was 6.5 and platelets were 18 which meant he needed a transfusion of both in addition to his chemo. Fortunately, this chemo only runs over 5 minutes however, the clinic technically closes at 6 and the blood transfusion should run over 3 hours and the platelets over 30 minutes so trying to get them all in was going to be tricky including time for the orders to be placed and fulfilled. It still blows my mind that things like this can occur at a leading treatment facility at any rate the plan was to run the platelets, chemo and then the blood transfusion. We could transfer to the emergency room if we wanted to complete everything but the doctors ensured us he should receive enough before closing time.
We also discussed Seth's magnesium levels because we have been watching those closely as he needed IV mag in the past. He was on the low side of the scale at 1.1 so we'll increase his dose and hope it doesn't cause too much more poop. It's a balancing act because he needs the magnesium but it can cause diarrhea which includes the magnesium being released. So we'll see how he does over the next few days with the increased dose. The plan is to have VNA come Thursday to do a full lab workup and we'll see if he needs any further transfusions or IV magnesium as a result. We won't be surprised if he needs either because the last round he got both.
We headed over to the infusion room to get things started. Here is Seth keeping busy during his blood transfusion.
He was shut off about 6pm and we were headed home. We'll see how he does over the week but we'll hope to be home until Monday when we go back for another round of Vincristine, intrathecal chemo, and a follow up with the GI team.