Tuesday, July 17, 2007

Water, Water Everywhere

July 17, 2007

Eleven Observations Comparing Cyclophosphamide with Etoposide:

11. Etoposide is easier to spell.
10. Etoposide dose is 21 days out of 28; cyclophosphamide is everyday.
9. Etoposide is refrigerated (even when you travel); cyclophosphamide sits on the counter.
8. Etoposide is an ugly brown gel cap about 3/4" long; cyclophosphamide is a perky aqua blue tablet smaller than a mini M&M.
7. Etoposide is given at 6:00 a.m. rain or shine, school day or holiday; cyclophosphamide is given with breakfast.
6. Both require avoiding St. John's wort (are any of you thinking this is a great loss?), but
etoposide requires avoiding grapefruit, while cyclophosphamide allows grapefruit consumption.
5. Cyclophosphamide requires an uptick in fluid intake (more water, juice, or if you think creatively, like Erin does, more juice bars, ice pops, Lil Scribblers, watermelon, cantaloupe, grapes, and so on).
4. Etoposide is a topoisomerase II inhibit
or, related to the toxin found in the American Mayapple; Cyclophosphamide is a nitrogen mustard alkylating agent. What does that mean? Both are toxic agents that kill cancer cells, but they use different mechanisms.
3. Long-term use of etoposide sometimes leads to secondary leukemia; long-term use of cyclophosphamide sometimes leads to transitional cell carcinoma of the bladder.
2. Etoposide has allowed Erin's hair to grow back (somewhat thinly); hopefully, the same will be true of cyclophosphamide.
1. Etoposide has worked keeping Erin's tumors in check for the last 20 months; cyclophosphamide has worked keeping Erin's tumor in check for the last seven days.

Conclusions: Almost too close to call, though cyclophosphamide might edge out etoposide on most factors (except spelling and having a week off now and again). We will reserve judgment until we get twenty good months out of the new guy! In the meantime, we will head to the local clinic tomorrow to see where her blood counts will fall on this regimen.

So, in the spirit of adding more fluid into her life, Erin has spent the last week mostly in the water. Last Wednesday, she swam at Bill and Sue Burchill's with Adam, Nico, and Ian, and her new friend Bill. Thursday, she swam at the A&M Outdoor Pool with Carpenter's Kids. Saturday, the Mystic soccer girls came out to the lake for a swim and cook out. They meant to play soccer, but no one was willing to get out of the water long enough to put shoes on, so there they all floated, boated, jumped, and splashed, while the parents sat dockside enjoying water substitutes.

Erin also had her pal Clayton Sue Benson from Fort Worth in for Camp Buenger on Saturday for several days (and nights. . .is this reading like I haven't had as much sleep as I would prefer?), Those two girls' incorporation of water into their daily routine encompassed a range of activities. Many of them involved concocting strange brews, tonics, lotions, and potions (I think in anticipation of Harry Potter and the Deathly Hallows, scheduled to appear, then disappear from booksellers' shelves next weekend). They also built a model of the Gryffidor common room with craft sticks and sculpey (which as best I can tell had no relationship to water, but built on the HP theme) and followed a multistep process (that incidentally, according to the strict rules of wandsmanship, couldn't be started before midnight) for creating working wands. Check them out with "wand at the ready"!

Lest we forget the importance of hydration, Erin and CS insisted we spend the last afternoon at the Adamson Lagoon. There they made full use of the water slides, lily pad hazards, and other floating obstacles placed around the pool. They also managed to snag Nico while we were there for one last night of fun and fancy, with a three-person sleep over (I almost wrote a "three-way" sleepover, which might have crossed the line on this family-friendly home page).

So, that's it for now. See you at the water fountain.

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