(these are both "before" and "after"--see if you can tell which is which!)
Our tenative plan now is to first explore if stereotactic radiosurgery is really warranted--that means having another MRI, and maybe a second PET scan. This will happen in the next few days. It would be ideal to do the SR prior to starting chemo, but if we can't pull things together, we could do it in-between chemo cycles.
Secondly, Abby will have three more cycles of chemotherapy followed by infusion of her stem cells. We have cells left over from her previous collection. This is the actual "bone marrow transplant" process--these cycles will kill off all her bone marrow and the stem cells will recover it. The cycles will consist of different drugs at higher doses than she had first time around, so her recovery time will be longer from each.
The first two cycles will be similar to what we had before, just with different drugs. We hope to do this at BDMC--both Dr. Graham and Dr. Abella have said that they would work to this end to minimize the amount of time we have to be traveling. Like before she will be inpatient for 4 days each cycle, then we go to Tucson for her stem cell infusion, then we watch her for the next 10-14 days while she recovers from being neutropenic, and it is likely she will need units of packed red cells and/or platelets.
The last cycle will consist of busulfan and melphalan at very high doses. For this cycle, Abby will be inpatient at UMC for about a month. Dr. Graham made no secret of the fact that this cycle would be unpleasant.
After a quick exam, we were back in the car to run to Amy's parents' to eat dinner and pick up Elizabeth, and then we were on the road and home by 7:30. Whew.
We're going to try to start the treatment as soon as possible, so please pray that we can get all the red tape out of the way. Please also pray that we can get some definitive direction regarding the SR radiation therapy, we have conflicting information now.
On a happier note, we were able to remove Abby's incision dressing this evening. Dr. Shafron had said it needed to come off on Wednesday, but we had no idea where we would be today, so he had Dr. Ha give me a set of skin staple removers and a quick lesson in surgery. (I'm exaggerating, obviously) Abby was very nervous (she had poor experiences with the removal of staples from surgery #2), but I had her scrub up and put gloves on so she could help by taking the staples from me when I was done. She laid her head on my lap and all 6 staples came out with absolutely no problem except the last--it was a little stubborn, and made her cry, but she quickly got over it when she realized we were done. The dressing itself came off without sticking too badly; Abby reveled in being able to scratch all the little tiny itches on the perimeter of the site where her hair is already growing back after the surgery.