As Jeff and I mentioned in earlier posts, the GFR is a radioactive kidney function test. The result of this test is put into the dosing formula for P and determines the amount of chemo he will receive on his next round. Pablo is meant to be super hydrated and stay hydrated throughout the testing. I have to admit, the hydration thing is not always that easy... it's hard to make a little one drink and drink and drink. I felt like we were good on hydration, but Pablo's results showed a slight decline in kidney function from his last test. He is still in the normal range (although the low end) and his chemo dosing will not be affected. Dr. M didn't seem too concerned and as usual, we will keep a close eye on him and continue to check his blood levels and his urine chemistry for any indication that there is trouble. The lower number can do with a few factors, one of which is the amount of chemo that Pablo has had to date. As we continue on this aggressive chemo schedule, Pablo's counts drop faster and take longer to recover.
This is normal, but something that needs to be watched closely. Dr. M did an abdominal exam and feels like there is no need to do immediate scans and advises to stay on schedule. Pablo's next scans, which will be a CT of his chest and an MRI of his abdomen and pelvis are scheduled for mid-April. These will serve as his official "end of treatment" scans. That's right! We have decided after much much much deliberation to end Pablo's chemo with this next round. Jeff and I have gone over it thousands (literally) of times in our own minds, with each other, with Dr. M, with other Wilms' parents, with other parents from our floor and in prayer. We feel great about our decision to follow Dr. M's original treatment plan for Pablo and look forward to that end of the tunnel light we have heard about so much!
We also received Pablo's echo results yesterday. We were incredibly pleased and relieved to find out that Pablo's heart function is EXCELLENT. This is Pablo's official "end of DOX" echo. This does not clear Pablo for life, but we know now that there were no immediate side effects from the Dox. His heart is meant to be under close watch for the rest of his life, however and he will be restricted in certain areas due to this... like weight lifting (hmm, this could be one of those blessings we keep hearing about).
So, here's where we are today... Pablo's counts are on the rise. White blood cells and ANC are coming up nicely, but his platelets are taking longer to recover. We are hoping for admission next Monday, if not sooner, and we will be in for four nights of chemo.
In closing, I have a request. Our friend from 4W, Thomas, is in need of prayers today. As I write this, he is in surgery. We are praying and hoping for the best possible outcome. Thomas and his mother, Tish have been an enormous inspiration to me and I ask all of you to hold them in your hearts today.