As per Wonderboy usual, Max is responding with no obvious side effects to this radiation treatments. He's halfway through the treatment with 6 appointments to go. When his tech's come out to get him, he marches right in by himself and is back out in less than ten minutes (which includes taking his shirts off, getting set-up on the table and then redressing when the radiation is finished). I did start giving him zophran (anti-nausea med) starting Thursday. His appetite seemed to be dipping a little following the radiation... and that's about the last thing he needs!
Megace
The Megace (appetite enhancer) seems to be working already. He's certainly not hungry all the time, however, he is saying, "When's dinner gonna be ready? I'm really hungry!" What music to our ears. Of course, then I have to make something he'll actually eat. Currently, boxed Mac & Cheese and Cup O' Noodles are tops on his list; bottom on my list for any nutritional value and protein content. I'll find something that makes us all happy eventually.
MRI & MIBG Scans
Max had an MRI and MIBG this week. His MIBG scan looks exactly the same as the previous - no increase in uptake but no decrease either. His MRI shows more enhancement than the last (which is not what we want to see), however, when comparing the two scans if there were more disease the MIBG would show more uptake. It's very complex and hard to explain, but we're having a leap of faith that what we're seeing on the MRI are cells being killed, not cells growing. (Scans are not typically taken at this point in the protocol, so the doctors are trying to interpret data that they don't usually look at. Max is having all these extra scans for the nifurtimox study.) At some point this conflict in scan results will need to be resolved: all scans need to show a decrease in disease.
VMA & HVA Levels
This is something we haven't mentioned before but plays an important role in tracking NB. These are catecholamines that are traced in the urine and elevate in children with NB. On his chart the levels started going up dramatically about the time he recurred and was diagnosed. These levels are steadily going down, which also supports the belief that his disease is decreasing.
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