On Monday, November 16, 2009, Atia began the Maintenance phase - the last phase of treatment in the clinical trial. Though it was a glorious day, because it marked the beginning of a new chapter in our lives, it was a difficult day, too.
Atia's Oral Medications
Atia had a spinal tap which required she go under anesthesia. Methotrexate (chemo) was injected into her spine and Vincristine (chemo) into her port. That evening, orally, she was given Mercaptopurine (chemo) and Dexamethasone (steroid) -- A drug cocktail she would need to get used to, since she would be receiving it every three months.
At that appointment, we were given a calendar that mapped out her monthly medications; it turned out that she would still require DAILY chemo. We were shocked! We had been under the impression that it would be reduced to only ONCE a month -- WRONG!
It left us wondering: If she continued to take just as many medications daily, weekly, monthly, how exactly was this phase "easier" than the others?
Atia's Maintenance Phase Routine:
- Daily, she receives an oral dose of Mercaptopurine (chemo) - I crush the pill, mix it with orange juice (OJ), extract into an oral syringe and she drinks it.
- Weekly, she receives an oral dose of Methotrexate (chemo) - I crush the pill, mix it with OJ, extract into an oral syringe and she drinks it.
- Monthly, she receives (1) a push into her port of Vincristine (chemo) and (2) an oral dose of Dexamethasone (steroid), which she takes twice-a-day for five days straight - I crush the pill, mix it with OJ, extract into an oral syringe and she drinks it.
- Every Three Months, she has a spinal tap with Methotrexate (chemo) injected into her spine, in addition to all the other drugs as detailed in the second paragraph above.
Atia also takes a series of supporting medications that offset the side effects caused by the chemo and steroids, including Ondansetron for nausea, MiraLax for constipation, Tylenol with Codeine for headaches and joint pains and an antacid for heart burn. There are times when she takes seven oral medications before going to bed and five upon waking up the next morning.
It's an intense phase and it's quite long; for Atia, it's a total of twenty months. But, when she's done with this phase she will have completed the clinical trial and will be done with treatment.
It was on the first day of the Maintenance phase that we learned Atia's last day would be July 10, 2011.