MTX Follow Up

My patient is doing better, clearing MTX slowly but surely.  It's been a few days now (96 hours to be exact) and his level still stands at around 4 so he has a long way to go.  Aggressive hydration and diuresis helped him out although his creatinine is still rising bit by bit.  Clinically he looks well, yesterday he was just lying in bed reading on his tablet!  We can't let him go until the MTX clears so now we just sit tight and hope his kidneys will make it.  Good thing we didn't have to order the antidote Voraxaze.  In addition to taking up to 48 hours to arrive, it costs $25,000 USD for a dose!  And because of the way the healthcare system works here, most of that cost would be shouldered by the patient.