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Day Two of Round Three of Volume Two

by Tom on January 26th, 2010

Here I am, coming to you live from Virginia Mason hospital on the second day of the third round of high-dose Methotrexate!

Last night we began the MTX infusion around 6:30 or 7pm. It finished near 11pm or midnight. I’ve had a bit more nausea this time around, but nothing so bad that we can’t stay ahead of it with Lorazepam (Ativan). This also has the side-effect of making me a little loopy; I completely forgot that Dr Norman came by to visit this morning!

It is very important to have a teammate that has all of his/her marbles, because sometimes you lose yours. Thanks Jana!

He came back by to reiterate that he DID, in fact, stop by and to re-mention what we’d discussed earlier.

As for the rest of the day, he schedule calls for 24 hours of “grace” before we start sending in the rescue dose of Leucovorin.

The Methotrexate works (generally) by pretending to be one of the nutrients needed during the cell replication process. When a cell (let’s suppose a lymphoma cell) starts to duplicate, it needs raw materials like Folic acid. MTX finds the places that are seeking Folic acid and grabs onto them, locking them down. Without the ability to absorb Folic acid, the cell ends up starving to death.

The “rescue dose” of Leucovorin is able to sneak around some of the MTX lock-down. We give the MTX 24 hours to work on starving the really fast dividing cells, and then bring in the Leucovorin to start saving the stuff that hasn’t already been caught replicating.

Early bird gets the chemo.

From → Treatment Phase

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