Update from Boston

Heath is going to start Etoposide/Ifosfamide chemo today. This is the first of two rounds that he will get while in Boston.

They are going to administer it a little different here than they did at Moffitt for a couple of reasons. First, he will get a lower dose due to the fact that he is getting Photon radiation which can affect the bone marrow slightly and put him at more risk with his blood counts. Second, they will give both types of chemo to him at a high rate over one hour for each instead of a high rate on the Etoposide and continuous over 23 hours on the Ifosfamide/Mesna. The reason is because they have to give him Mesna to keep the Ifosfamide from damaging his bladder and the Mesna is considered a heavy metal. Since Heath is getting radiation, they need to make sure there is no Mesna in the radiation field during his Photon treatment because it could cause the radiation to scatter which would cause undesired results. Therefore they will not give him any Mesna for an hour or two before he gets his Photon treatment. Also, Heath was having bladder pains a couple of days ago. They have done two urine tests on him and he appears to be ok to proceed but we will be keeping a very close eye on any symptoms related to bladder pain.