Vinblastine it is

Adrienne saw the new oncologist at NVCI yesterday to get counts, assess her pain, and determine how to move ahead. Her CBC showed low hemoglobin, which is typical when she has a lot of disease, making her pale and tired. Still, she finished the first summer term and started a new term on Monday. Her lymphocyte count is almost nonexistent so she needs to be extra careful as this makes her susceptible to opportunistic infections. Her CT showed a small problem around the bile duct that connects the liver and gall bladder. The elevated alk phos confirms this so it's something we need to watch. This liver issue surfaces from time to time and typically resolves on it's own so we'll just keep an eye on it.

On to the pain. NVCI has a new pain doctor who spent a lot of time with us yesterday. Both she and the oncologist did thorough pain evaluations and no one can figure out where Adrienne's pain is coming from. There's nothing on the CT that explains it and pressing everywhere doesn't make it worse. We can only assume that it's coming from bone lesions. She's had these before and they can be quite painful. We got several new prescriptions so she can escalate as the pain gets worse, and hopefully, she'll have less breakthrough pain.

The general feeling is that everything showing in Adrienne's lungs is disease so we need to move ahead with treatment. We made the decision to do vinblastine every other week. This is the "V" in ABVD. Adrienne never did ABVD but she's had vinblastine before, though not since 2002. With Hodgkin's, you can often go back to old drugs and we're hoping that's the case now. She starts tomorrow (Thursday) and we're counting on this being relatively easy.