Tuesday, December 1st

Tristan’s blood counts have dropped, as they’ve been expected to do, and today he is neutropenic. We had a clinic visit today; his labs were drawn and he was given vinchristine and doxorubicin, as his final chemo treatments during the first half of Delayed Intensification.

Now we wait. For Darth Nadir. The nadir is the lowest point of something. In pediatric oncology, it gets used as a verb. Had Tristan nadired yet? I’m asked. Today only his neutrophils are low, but over the next two weeks, all of his counts will drop, some of them to zero.

Then, when the counts are high enough again, we go on to the second half of Delayed Intensification. Which will make his counts drop so far that he will probably need blood products — platelets and hemoglobin. Ninety percent of the kids do, I’m told by our outpatient nurse. We are scheduled to begin that second half, which consists of chemo four days in a row for two weeks in a row, on December 14th.

So, where we have Christmas depends on Darth Nadir. That is, when he comes and when he decides to leave. And, then, when we get to go home again after we finish Delayed Intensification will also depend on Darth Nadir. May the force be with us.

When I last wrote, we were all together as a family at a hot springs B&B in Ukiah, halfway between home and the city. From there, Gary took Tomas and Phoebe home, and I brought Tristan back to San Francisco for another appointment at the clinic on November 24th. That appointment went fairly smoothly, thanks in part to the fabulous Nurse Evan, who possesses the unique ability to put Tristan into a meditative trance before he takes his blood pressure. Tristan HATES the blood pressure cuff, and, when anybody else takes his pressure, they soon decide they want to hospitalize him for astronomically high readings — which, in fact, are only reflective of a furious three year-old.

If only Nurse Evan could do everything. Seems he’s not chemo certified. Today Tristan was furious, probably because when he’s neutropenic he’s very grumpy, about every single thing — the cream to numb his chest, the needle accessing his port, the sticky adhesive over it. It was not an easy day. Thankfully Tomas elected to join us on this trip to the city, and he’s been so helpful. In the clinic this morning he did his best to distract Tristan with video games on an iPad and helped dress up Tristan’s favorite stuffie — Blue Dog — in a police uniform supplied by one the child specialist social workers.

Between these last two clinic visits we had five days at home and celebrated Thanksgiving at our place with my parents and Chris and Agi. The kids are extremely excited, as we’ve all just learned that Agi is currently gestating for them a cousin. Tristan, in particular, is happy to know he’s going to be bigger than somebody else in the family. Phoebe is generating mountains of artwork to celebrate the baby girl. Chris and Agi will need to rent a storage unit to keep it all, along with the boatloads of baby stuff I’ve got put away for them.

Back to Kneeland tomorrow…