Wednesday, October 26, 2016

Treatment Timeline: September 25, 2016 - Present

I wanted to make a post of Todd's treatment by date and day for me and others to keep track of our progress.  I plan on updating this from time to time.  I'm sorry for not keeping up with posts here, but things have been crazy busy every day.  The time goes so fast and it is easy to lose track of the days.  The Blogger App on my IPhone has also not been working, which has made it difficult to post; this means I have to do it on my laptop only. 


September 25, 2016:  Todd taken to the ER at Soin Medical Center, Beavercreek, Ohio.  Diagnosed with Splenomegaly, low CBC counts, and blasts in pheriphal blood. 

September 25 -29, 2016: Admitted to Soin Medical Center
September 29, 2016:  Discharged from Soin; Fly to Houston, TX.  Taken to ER at MD Anderson Cancer Hospital and Admitted.  Diagnosed with MDS with Secondary Acute Myeloid Leukemia.
October 4, 2016: Treatment Decided.
October 5, 2016: First Day of Induction Chemotherapy.  DAC + CIA; 5 + 5 day regimen.
Dr. Stefan O. Ciurea, MD, Transplant Doctor came in for Bone Marrow Transplant consult.  Suggested testing the kids for Haplo Match. 
October 5- 9, 2016: Days 1-5 of DAC chemotherapy
October 10 - 12, 2016: Days 6 - 8 of Idarubicin Chemo
October 13- 14, 2016: Days 6 -9 of Clofarabine. Ted Cade, Paul Cade, and our 3 kids submit DNA/HLA blood tests for bone marrow transplant match.
October 10- 14, 2016: Days 6 -10 Cytarabine
October 14: Last day of Chemotherapy. First Lumbar Puncture and Intrathecal Chemo: Methotrexate
October 18: Second Lumbar Puncture and Intrathecal Chemo: Cytarabine.  Discharged from Inpatient Stay at MD Anderson
October 18, 2016 11:10 Todd starts running a fever.
October 19, 2016 Todd to ER at MD Anderson.  Re-admitted to Transplant Floor 17.
October  21   : Moved to Floor 16; Room 1678
October 24: Discharged from Hospital 2nd time. 
October 24 - Present Staying at Springhill Suites by Marriott, Pearland, TX 
October 26, 2016.  First Out-patient Fast-Track appointment.  Platelets needed (2,000) along with potassium and magnesium. Hemoglobin 10!  No whites or ANCs.  Received platelet transfusion in ATC.
October 31, 2016.  Bone Marrow aspirate.  Cycle 1, Day 28 Induction Chemo DAC + CIA.  Results: blasts at 20%

NOVEMBER 2016

November 4, 2016.  First day Todd had 0 platelet and 0 White Blood Cell counts.
November 5, 2016.  Todd runs a high fever and is taken to ER.  Is admitted to Hospital. Has a xrays and CT of head.
November 6, 2016  Confirmed fungal sinusitis infection in right sinus.
November 8 2016 another follow-up bone marrow from DAC-CIA induction. 
November 9, 2016 BM aspirate results at 38% blasts.
November 14, 2016  First hyperbaric chamber treatment.
(Nov 14, 15, 16, 17, 18, 21, 22, 23, 29, 30) 10 days of hyperbaric treatments at Memorial Herman.
November  18, 2016  White cell transfusion from donor.
November 20, 2016  Todd spikes a high fever; maybe from the white cell transfusion. Started new round of IV Antibiotics.
November 22, 2016.  Started Second type of chemo treatment to fight MDS/AML.  Day 1 of DAC
November 22 - 26, 2016. Day 1-5 of DAC
November 22, 2016.  Bone marrow biopsy: blasts decreased to 24%.  Maybe due to a late response from first round of induction chemotherapy.
November 23  Started second chemo regimen along with 5 days of DAC: Venetoclax (Venclexta ) 100 mg tablet per day with Posiconozole and Voriconozole tablets added; continued Ambisome antifungal IV treatment.
November 30, 2016.  Todd is discharged from the hospital to outpatient care. Last hyperbaric chamber (10th) treatment.  First note of an abnormal EKG.

DECEMBER 2016

December 2, 2016.  First outpatient appointments post-discharge from third hospitalization.  Ambisome infusion, CBC labs, reviews, every Monday, Wednesday, and Fridays; along with some Sunday transfusions of platelets.  Some infusions of Potassium and/or Magnesium infusion balls sent home. 
December 2, 2016.  Appointment with Dr. Christopher Benton
December 3, 2016.  Move into Apartment on Brompton Road, Houston, Texas.
Dec 5, 7, 9, 12, 2016: Outpatient appointments.
December 9.  Dr. Benton came by ATC and increased Venetoclax dose to 200 mg. until Sunday.
December 11.  Increased dose of Venetoclax to 400 mg. (no -azole drugs)
December 13, 2016.  Appointment with Infectious Disease Dr. Shelborne; Must continue on Ambisome or fungal infection could become invasive.  Was shown to be invasive from first biopsy of the sinus, but infection was caught very early.
December 13.  Bone Marrow Aspirate.
December 14.  Dermatologist Consult with Dr. Pacha.  Biopsied spot on right shin for fungal infection.  Out patient appointments: CBC/LAB, review, Ambisome, 2 units of RBC; 1 unit platelets and ball infusion of magnesium.
December 16.  Outpatient appointments including Dr. Benton to review bone marrow aspirate results, check on continued care at MD Anderson due to change in medical coverage beginning Jan 1 2017.  Sample was not good to look at; only could estimate 10% blasts. Flow cytometry was done in addition to get better counts.  These results showed 33% blasts. 
Dr. Benton recommended a second cycle of Day 1-5 DAC plus 400 mg of Venetoclax.
December 18.  Day 1, Cycle 2 of DAC plus 400 mg. of Venetoclax.  DAC given by outpatient infusion for five days.  December 18-22.

December 23, 2016.  Fly home to see family for Christmas.


JANUARY 2017
January 2. Bone marrow Aspirate scheduled.
January 8.  Day 21 of Cycle 2 DAC + Venetoclax.
January 15.  Day 28, Cycle 2 DAC + Venetoclax.
January 16.  Bone Marrow Aspirate scheduled. 









                   


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