Neurological Side Effects of Ifosfamide Chemotherapy

The first series of Ifosfamide chemotherapy was completed on April 18 and in addition to a little more nausea than usual, Irene was having severe pain in her leg. Dr. Homsi saw her in the infusion center suffering from pain and admitted her into the hospital.    IV anti nausea and new pain meds had her feeling better and she was released the next day.

We received word that her sister-in-law, Hazel Hall, (who was married to her brother Byron who just passed away in January) had passed away on Friday, April 19.  Her funeral was scheduled for Saturday, April 27, and Irene wanted very much to travel to Washington DC to attend the funeral.

That is until April 23 when Irene’s nose started bleeding and we could not stop the bleeding.  Finally we took her to the ER where they put a nose clip on her nose and got the bleeding stopped.  She was also experiencing quite severe nausea at that time.  Blood and urine tests revealed that she was low on platelets and potassium.  With the infusion of platelets, potassium, anti nausea meds and a change in the pain meds, she was released the next evening feeling pretty good.

Our grandson Joshua Peterson, son of Gayla and Chuck, gave his farewell talk on Sunday, April 28 and we enjoyed a day with our family.  He has been called to the Dominican Republic Santo Domingo West Mission and left May 8.  He will go directly to the MTC in the Dominican Republic.

 

          Josh Peterson with his Happy Grandparents ready to go to the MTC 

            Josh pointing to his mission on the map in the Peterson home

     Josh with his grandparents and his mom and dad Gayla & Chuck Peterson

                                           Josh and several of his cousins

For some time we have planned to go to Nauvoo with Robert and Diane Latyon to visit President Russell and Sister Karen Gilliland.  The Laytons and the Gillilands served with us in the Mesa Arizona Temple presidency.  The trip was scheduled for April 29 – May 4 with a flight into St. Louis and a three hour drive to Nauvoo.  That trip was on and off again depending on how Irene was feeling until late Sunday afternoon, when the decision was made that we were going.

 

      President Russell & Sister Karen Gilliland, Irene, Dianne & Robert Layton

                                Sister Gilliland with the team of horses

     Attending the senior couple's production of Rendeveau in the Cultural Hall

               President Gilliland at the Browning Home and Gunsmith Shop

        Sister Gilliland, Irene and Dianne in the living room of the mission home

 Robert, Daryl and Pres. Gilliland waiting for 40 young performing missionaries

                                                      Nauvoo Temple

We had a wonderful reunion with our dear friends in Nauvoo and Irene did well in that she could rest as needed and do as much or little as she felt like doing.  President and Sister Gilliland do an amazing work in presiding over seventy plus senior couples, twenty single sisters, twenty young single sisters and about forty young performing missionaries.  We met many of these wonderful missionaries and appreciate their service.  We also had dessert in the mission home with our friends President and Sister Spencer Condie who are the president and matron of the Nauvoo Temple on an evening prior to attending the temple the next morning.

The second series of the Ifosfamide chemotherapy was started on May 8 with a full day in the infusion center at Banner MD Anderson in Mesa.  As with the first session, Irene came home with a back pack with a pump and two liters of medicine that was pumped into her body through her port.  When I brought her home after the second day of chemo, there was a noticeable change in her behavior.

Some of the neurological side effects of the chemo drug (Ifosfamide) that she was taking in this series may be confusion, slurred speech and difficulty in speaking.  Wednesday when I got her home it was obvious she was having those neurological side effects.  After about three hours, I looked up the management for that situation, and it was to call her doctor IMMEDIATELY.  I called Dr. Chuck, Gayla's husband, and he recommended we take her the ER. 

The ER doctor ordered several tests (blood, urine, CT scan of her head, chest x-ray and an EKG) and decided to hospitalize her.  They treated her the next day in the hospital with various medications and IV fluids.  For about 36 hours she was not able to answer questions, track a conversation or speak very coherently until about 10:00 p.m. Thursday night.  Dr. Homsi was checking her throughout the day and was pretty sure the symptoms were a result of the chemo and it appears that he was right. Several additional tests were administered.  It sure felt good to be able to carry on a pretty good conversation with her Thursday night.   Some of her responses were pretty funny.

 

The CT scan taken in the ER indicated there may be some swelling in her brain, but it was not a very definitive scan so an MRI of her head was taken the next day. Dr. Homsi came in and gave us the report on the MRI which was that she has two lesions (cancer tumors) in her brain. One is the size of a marble and the other is smaller.  Dr. Homsi and Dr. Callister, radiology oncologist, consulted and are recommending radiation to destroy the lesions.  Dr. Callister explained that they have radiation technology today that they can specifically and precisely radiate the tumors without full brain radiation or damage to surrounding tissue.  We will see Dr. Chamberlain, who specializes in these procedures, next week and the radiation will be done the following week.  A more refined MRI of her head will be needed to pin point the radiation.  After the radiation, Dr. Homsi will consider another chemotherapy drug that we can try to destroy the other tumors in her body.

 Irene believes that the neurological side effects are a blessing in that the brain tumors may not have been identified without the CT scan in the ER.  The fact that they are small, they are more easily treated with radiation. She was released from the hospital on Saturday, May 11.

 Friday night as I was leaving the hospital she started to cry, which I have rarely seen in the four plus years she has been suffering from this cancer treatment.  When I inquired about the tears she expressed that she was just so sad that her children and her sisters and I had to worry about her.  That is typical Irene.

Today, Sunday, May 12, 2013, was Mother’s Day and she spent it with a trip to the hospital for a Nulasta shot and then dinner with Dana and Steve’s family.  We were invited to attend the Mother’s Day call from Elder Jason Garry from Mexico and Elder Joshua Peterson from the Dominican Republic.  This evening the Garn Family got together at Kevin and Tara’s to honor all the mothers.  Her favorite gift was a video put together by Byron highlighting each of the 46 members of our family.