Malcolm's ANC remains at zero. Other components of his white blood cells are recovering so it is only a matter of time. There is no concern that the ANC is taking a long time to rise - some rounds it will take longer than others and the reasons for this are not clearly understood but it does not make any difference to the final outcome. So the only concern is that he remains very susceptible to infections while it is so low. We are hopeful that his ANC will start rising tomorrow so that we can go home Wednesday or Thursday. Hemoglobin is 85 and platelets are a whopping 468!
Malcolm is scheduled for an echo (ultrasound of his heart) either tomorrow or Wednesday. They do one at the end of each round to ensure there are no short term impacts on his heart. One of the more serious side effects of the treatment he's on is heart damage, as the drugs are particularly toxic to the heart. Damage can occur in the short term, though this is quite rare and is more likely to occur in children who have serious heart defects/damage, which Malcolm does not have. However, if heart damage is occurring they would consider changing his treatment. It is more likely that heart damage will become apparent over the long term (in a decade or two) so he will be monitored at least annually, likely for the rest of his life. But even the long term effects are relatively rare.
It is very hot here in Halifax - we were out for a bit this morning but will remain indoors until this evening when it's cooler.
Mary Ellen
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