Adios Ommaya

The Ommaya Reservoir will NOT happen – and Rianne is relieved! On Monday Dr. Cook performed a Lumbar Puncture on Rianne’s lower back and drew some spinal fluid to test it for cancer. He found her fluid to be cancer free. He then injected the first dose of the Intrathecal Chemotherapy drug called Methotrexate in the same hole as he drew the spinal fluid from. The Cerebral Spinal Fluid (CSF) flows through the spine and also flows around the outside of the brain – which is where her tumor is located. The injection of Methotrexate will flow upward through the spinal cord, around the CSF surrounding the brain and will ultimately attack the tumor.
The Ommaya Port would have accessed the tumor directly from above, but time constraints have now made it an unnecessary procedure. The Intrathecal Chemotherapy which Rianne will endure consists of 8 treatments – 2 per week for 4 weeks. Right now we are in Week 1 with her 2nd injection scheduled for tomorrow. Surgeons who install Ommaya Ports (a Nuerosurgeon is required) are very busy right now. To arrange for the surgery a “consultation” with the surgeon must first take place. The earliest opening for a consultation was next week. Surgery would follow and the earliest a surgery could be scheduled would have been the following week, which is Week 3. By then she would be halfway through the treatment before the Ommaya Port would have even been installed. Also, she would have an incision to deal with, as it would need to completely heal before radiation were to start, which could be weeks longer. With that said, the decision was made to administer ALL 8 of the Intrathecal Chemotherapy Injections through her spine twice a week for 4 weeks, instead of waiting for the surgery to be scheduled. Time is critical as we fight the cancer and waiting was not an acceptable option.
In the morning we will return to Coos Bay for a Blood Draw and for the 2nd Intrathecal Chemo Injection, which will be the second drug called Cytarabine. In addition to the intrathecal drugs, on Mondays for the next 3 weeks, Oncology Nurses will administer Rituxan through the Port in her chest. This will be done for systemic coverage throughout her body to continue to kill the cancer cells. Rianne’s lymphoma is a very serious condition and her Oncologist is continuing to treat it as such.
Rianne has been in average spirits today. She is relieved to know that a hole won’t need to be drilled in her head, but she’s also exhausted. Sometimes she and I look too far ahead, which often becomes overwhelming. As we’ve said before, the best way to fight this cancer is one day at a time. Tomorrow is another day!