[stanford_status] Dec 28, Thu - Chemo today - transfusion tomorrow

John R Larsen john at larsen-family.us
Fri Dec 29 00:11:31 EST 2006

Hello Everyone,

Stanford had his third round of gemcitabine today.  Dr. O'Shea was 
encouraged by how alert Stanford was at this appointment.  He said, 
"It's nice to have a conversation with all four people in the room 
instead of only three."  Stanford was talking about food he wants 
his mom to make, video games, and movies.  At the previous three 
appointments Stanford has been very tired, mostly sleeping through 
them.  Stanford's next appointment for chemo is scheduled for 
Thursday, January 4th, at 1:30 PM.

Stanford has developed some bruises on his back on the skin above 
his ribs.  I pointed them out to Dr. O'Shea during today's 
appointment and he said that most likely Stanford's platelet count 
would be too low to have chemo today.  However, he was pleasantly 
surprised when the lab work came back because it showed Stanford's 
platelets were at 111,000 and his other counts were also all within 
range.  Ten days ago his platelets were at 84,000.  I've posted the 
latest hematology and chemistry results on the 
http://StanfordLarsen.org website.  

The blood chemistry results show that his ammonia is lower at 51 
compared with 62 ten days ago, but this is still way high.  His 
albumin is also a little higher, but still too low.  Other 
indicators of a struggling liver are the Total Bilirubin and Direct 
Bilirubin, which have both increased a lot in ten days and are both 
high.  The white's of Stanford's eyes have a slight yellowish look 
as does his skin.

Stanford's hemoglobin (HGB) has dropped to 7.4, which is the lowest 
since the crisis of Nov 21st and is tagged with a "Panic" on the 
printout.  His hematocrit (HCT) has also dropped.  Based on these 
numbers it is time for another blood transfusion.  Stanford will be 
going to Southern New Hampshire Medical Center tomorrow morning 
(Fri, Dec 29th) at 9:00 AM to receive two units of blood.  It takes 
about 2.5 hours to transfuse one unit of blood, so we'll be there 
until late afternoon.  (By the way, hematocrit is the the ratio of 
the volume occupied by packed red blood cells to the volume of the 
whole blood.)

The day after Christmas (Tuesday) was a very difficult day.  The bad 
days almost make me despair.  Yesterday, Dec 27th, was a much better 
day.  Stanford was awake a lot more, had a shower, and was able to 
go to the movie "Eragon" in the evening.  The good days give me 
hope.  Today started out good, but the chemo always knocks him down 
and makes him very tired.  He has already needed some liquid 
oxycodone for break through pain.  This is earlier than the other 
two rounds of gemcitabine, but not unexpected.  

Stanford's attitude is still good.  He said last night that he has 
to have a good attitude because if he doesn't have a good attitude 
then he would give up and then he would die.  We are amazed at his 
courage and hope.  Attitude is so important.

I took some pictures of today's treatment starting with pictures 
outside the clinic and then inside.  These are all on the 
http://StanfordLarsen.org website.  Before this whole experience 
starting in June we had no real idea of what "chemo" was.  You can 
see the IV stand and the bags hanging from the hooks.  These go into 
the pump and from there through his port directly into the blood 
stream.  The zofran he gets as a premed really makes him tired and 
the gemcitabine makes him sick.  Notice that his favorite blanket is 
a Sponge Bob blanket that says "Today is the Best Day Ever!"  He 
looks pretty good in one picture where he is using his laptop while 
waiting for lab results.  The later pictures show him pretty much 
wiped out by the drugs.

We take it a day at a time.  Each day is different and unexpected 
things happen.  The days are very full and are very interrupt driven 
by whatever comes up.  We are so thankful for all the support and 
encouragement we receive from friends and family.  It would be ever 
so much more difficult without this help.  Please keep Stanford in 
your thoughts and prayers and with God's help he will make it 


John R Larsen <john at larsen-family.us>

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