Day Two of Interleukin-2

I thought I might not write everyday, but it's a good history for us, so here's what happened today.

Written at 11:00 am:

Mark's response to the first dose of Interleukin-2 yesterday was enough that the 11 pm dose was not given. Dr. Taylor explained this morning that he expected this outcome because Mark does not produce cortisol (side effects of the treatment over a year ago that affected his pituatory gland), resulting in a stronger immune response. Besides the nausea and rigors (extreme chills and shakes), his heart rate increased and his blood pressure (top number) dropped to around 88. Below 85, intervention is needed to keep it from going any lower. He didn't need that, but they determined that another round of IL-2 would not be wise until his blood pressure was higher. If a dose it dropped, they prefer the one at 11 pm. Patients fare better during the day, and if there is a major problem, there are less doctors and nurses available at night. Another problem is that his creatinine levels ramped up in his kidneys, so that is being monitored, as well. 

He was finally able to rest through the night, except for routine check-ups every couple of hours. This morning he was stable enough for his 2nd dose which was given at 7 a.m. He hadn't eaten anything yesterday after the IL-2. This morning he was able to eat 4 small bites of breakfast before side effects kicked in. Almost exactly an hour and a half afterwards, he developed rigors again. This time warm blankets did little to help, so a dose of 25 mg of Demerol was given through the IV which went straight to his blood stream, calming him in seconds. That was amazing! 

We were concerned that with missed doses he may not get the immune response needed to fight the cancer, but that is not the case. Because Mark's immune system is responding so dramatically, he may not need as many doses to do the job. Some folks need more doses to create an immune response. So, while 14 doses is the maximum. no one gets that many, and it is possible to get as few as three in one round, and still have a positive outcome. It is likely that his body will react even more quickly the next time we come to the hospital for IL-2. The T-cells know what they are supposed to do so they jump into action as soon as they get the message to go. 

The doctors and nurses are spectacular! Each nurse has been competent and kind. Most have worked with IL patients for years so they know what to expect and how to alleviate side-effects quickly. 

Written at 7:00 pm:

There was a pow-wow this afternoon with a team of doctors to determine if Mark should have the next dose. The decision was YES, so the 3 pm infusion was given. Just like clock work, an hour and a half later, the shakes began. So...the magic number is an hour an a half--we can count on it. Nurses hurried in with warm blankets and Demerol. Within seconds the shakes stopped again. A mild headache has continued, and he is nauseaus. No dinner, for sure, but he is drinking a little. Oh, and his skin is getting red like he has been out in the sun, and he is running a low grade fever. His blood pressure is right at 85 so he got a bolus (literally a bag of water given intravaneously) to help raise his blood pressure. It brought it up to 88. He can get three bolus before medication is required. 

Mark doesn't feel great, and he sleeps most of the time, but it has been better so far, than we thought it might be. We don't find out until 9:30 what the doctors will determine for the 11 pm dose, but we feel quite confident that it won't be happening which will make for a better night's sleep! 

Oh, there's one more thing I forgot to write about yesterday. When we picked up the Daily Joy book that was in our special box, we opened to the page with the ribbon bookmark. Rachel assured us that she had not placed it there. This is what we read:

DOUBT NOT, FEAR NOT

"Look unto me in every thought; doubt not, fear not." (Doctrine and Covenants 6:36)

"Our focus must be riveted on the Savior and His gospel. It is mentally rigorous to strive to look unto Him in every thought. But when we do, our doubts and fears flee . . . Faith in Jesus Christ propels us to do things we otherwise would not do. Faith that motivates us to action gives us more access to His power." 

Our theme has always been "Fear Not, I am with Thee, " so we felt that it was there just for us. 

With love and appreciation,

Ane & Mark