Advice needed regarding starting round 3 a day late

[a mom]

So as it turns out, day 1 of round 3 falls on the day the NATO summit is in Chicago, and the staff at Northwestern wants us to skip my son's treatment on Monday and start it on Tues. He would then be treated Tues., Wed., Thurs, Fri., and the following Monday. Skipping two days between his treatments makes me even more nervous than skipping his Monday treatment, which already makes me nervous. Plus, what happens to the Tues. Bleo treatment? Would we need to change that too? I asked if having my son go to the hospital on Sat for his Day 5 would be an option, and they are looking into it. Has anyone had any experience with skipping a day? From what I've read, it sounds like it's not advisable even if WBC is low. Please help either put my mind at ease or give me ammunition to fight it.
Thanks.

[Smilemjc22]

wish I could help. We are at the James OSU cancer center, and my son goes to chemo there, but they are closed on the weekends. So on the weekend we go to the OSU hospital to get his treatments and not skip any days. I hope things work out for you and your son. Good Luck!

Steven's Mom

[hbr777]

Here is some info, including a quote from Dr. Nichols (Lance Armstrong's doctor):

Holidays

Cancer can happen to you at any time of the year. Strangely, though, a lot of doctors and hospitals will try to get you to postpone your chemo because of holidays. That is not acceptable. If you begin chemotherapy in mid November, you could get moved around all over the place due to Thanksgiving, Christmas and New Years. Don't let them get away with this. As Dr Nichols says, "We make arrangements to treat our patients through the holidays on schedule. Cancer doesn't observe Thanksgiving..."
http://tcrc.acor.org/chemo.html

My husband's treatment fell over Thanksgiving - they hospitalized him so that treatment would continue as planned.

[AustinsMom]

Hi a mom,

We had a similar experience last week when our Hospital moved into their new Children's Center and the place was virtually shut down for a few days. This meant Austin's treatment schedule had to adjusted slightly and our Oncologist said it would pose no problem. He began his first cycle on a Saturday ( had to do it as an in patient ) and ended on Wednesday. We waited until the following Monday for his first Bleo push.

Now as for skipping two days during your long week....boy, I would push for them to accomodate you on Saturday, simply because personally, I'd want to just get it over with and start recuperating! Some others on this forum who are more medically knowledgeable may be able to answer as to whether there is any risk involved by doing so. We are getting treatment at Johns Hopkins in the outpatient center and they are closed on week-ends, but the in patient department, directly across the hall, of course is equipped to do the chemo. I think it all comes down to a matter of insurance and the cost and availability of providing a room and bed etc. The clinic told us not to worry about it, that this kind of thing happens all the time and that the Insurance companies never turn down requests for in-patient care when it involves chemo patients. I'm sure your Oncologist will make sure your son 's treatment is not compromised.... but sometimes they are caught up with a gazillion other patients and problems and things can get overlooked......so, yeah....sometimes Mama Bear has to be a little assertive! ( Is that enough ammunition for you.....I can give you more if you need it!)

Good Luck!
Diane

[CancerSux]

Mama Bear has to be a little assertive!

Mama bear needs to be assertive in this case - VERY assertive (contact the experts to talk to your local onc if you need to).

Starting a day late is not a big deal - skipping 2 days for a 'weekend' is - he should be admitted inpatient if need be, but 5 days need to be in a row! OR ... they can do a 4 day regimen (each day would have ~20% more), but the latter is less fun.

T

[a mom]

I've gone ahead and risked the wrath of the staff -- and probably my son for overstepping my boundaries -- and e-mailed his doctor to let him know that I would prefer to stay on schedule. Hopefully, we won't be making our way through angry mobs of protesters and tear gas to do it! My mother lives 1-1/2 miles away so we will probably just stay with her and walk over since a lot of the streets will be blocked off to traffic. Sheesh. Like it isn't hard enough.

Thanks for your replies. It's nice to have a whole team of opinions.

[AustinsMom]

That's a G-O-O-O-D Mama Bear........maybe you could "forget"to mention to "Baby Bear" that you intervened on his behalf ??

Your idea of staying with your Mom is probably wise, unless there's a hotel closer?? I have no idea what the streets will be like in Chicago at an event like that, but they can turn ugly quickly when we have them here in D.C. I like to hope for the best and prepare for the worst.

You may have heat,humidity, extreme fatigue, huge, unruly crowds and/or tear gas.... or something similar to contend with. First, I would, discreetly of course, inquire with the Oncology Clinic to see if they have any suggestions or back up plans for patients on that day. If not........hmmmm..... rent a wheel chair, go to a paint supply store and buy a couple of those cheap white papery coveralls that go from head to toe, grab a couple of face masks, some latex gloves and couple of those lovely surgical caps next time your in clinic. Have your son hold a bucket in his lap....put a "hazardous waste " sticker on it and whatever else you can come up with that might just encourage folks to get the heck out of your way......Mama Bear is COMIN' thru !!

After all that......the chemo will seem like a breeze.

Hope it all works out!
Diane

[a mom]

Thanks, Diane
Hope Austin is doing well.

[a mom]

We were told yesterday that no one will be coming in on that Monday to do my sons first day of Round 3 and that it will be postponed to start on Tues. He will, however, have his fifth treatment on Saturday and not have to wait until Monday. I got the sense on this board that that was the most important issue so I guess that's how it's going to be. I'm sort of okay with it because I would hate to get my son in a dangerous situation due to my stubborness -- although I don't mind being stubborn if it's to his benefit.
Thanks for all your input.

[CancerSux]

I got the sense ... that that was the most important issue

I think it is - they delay a day here or there all of the time (although not because 'no one will be at work' ... it is a hospital, I think you said, and those don't close), but getting the chemo in a row with no skipped days is important (sometimes a skip is unavoidable due to toxicities, etc, but this is not one of those cases).

Good job, momma bear!

[S P]

Either they need to:

- treat him like normal and start on Monday
- treat him starting Tuesday but compress the schedule a bit so he still ends up Friday (the European BEP is compressed over 3 days so this is ok)
- treat him starting Tuesday and make arrangements for him to get the last day on Saturday.

Period. End of story. No IFs, ANDs, or BUTs. What they're suggesting is nonsense and completely breaks protocol.

Edit: I see you've already gotten it taken care of via my option 3. Good job!