Diagnosis

We are having an incredible snow storm here with whiteout conditions and lightening. The wind is incredible. We are grateful to be on the opposite side of the building to avoid all the window rattling. James' room is actually pretty cozy.

A few hours ago, Dr. Weirmaa came by to give us James' diagnosis. The additional samples and testing confirm that he has B cell ALL (Acute Lymphatic Leukemia). He has the standard risk variety (there is also high risk and very high risk). It appears that this is the best of bad and that the treatment for this will be much less aggressive than for many other kinds he could have. We are grateful for God's mercy in this.

Tomorrow morning, James will have an MRI to further investigate his Bell's Palsy. Bell's Palsy can be caused by Leukemia tumors on the seventh cranial nerve. If that was the case, Dr. Weirmaa would have expected to see a higher white blood cell count and more leukemia cells in his spinal fluid than she did. It also appears that the paralysis on the left side of his face began improving before he ever had any treatment. I noticed some improvement Monday and Tuesday and even more by today. The issue here is this: If James' central nervous system is affected by the leukemia, he will need radiation treatment to the brain in addition to the regular chemotherapy. A colleague of Dr. Wiermaa's who is a pediatric neurologist came by today to see him. She will see him tomorrow and weigh in on the MRI results as well. If they determine the Bell's Palsy is not related to the leukemia , he can be treated differently under a pedatric cancer study that is working on ways to classify cancer in children more distinctly allowing for minimally invasive/destructive treatment. We are all for using what the job needs and no more, realizing that too much increases risks of future complications from chemotherapy.

You may already know that chemotherapy is a poison. The key challenge being to poison the cancer without seriously poisoning the child (in this case). Dr. Weirmaa told me today that with other major form of Leukemia (AML), 15% of the patients die from the treatment. With the ALL, one percent die from treatment. So any effort to learn how to maximize poisoning the cancer and minimize damage to the patient is a worthwhile endeavor. This is not an experimental program, by any means. Just a study to tweak existing protocols. It is a world wide study (here, Canada, Europe, Israel, New Zealand are the places she mentioned that I can remember), and Dr. Wiermaa told me that whenever they do studies of this type and implement the results, they often see a five percent increase in the success of treating cancer in children.

So, tonight James will begin two more chemo drug treatments. One he will get through his feeding tube (which I think will prove to be a great thing for him to have now), and one through his central line. So, March 1st will be James' "Day 1" of treatment. More than likely we will stay here through Day 8 at least. He will have another bone marrow then and depending on the results, we will know if we have to stay here longer or if we can 'commute'.

This first month of treatment is the most critical and the riskiest. He is most susceptible to infection (particularly to things like chicken pox and staph or strep infections) and secondary infections are the greatest risk in chemo patients. He will have relatively intensive chemo for the first year of treatment and then will continue 'maintenance chemo' once a month for another 2 years and 2 months, assuming all goes well to that point.

It is pretty certain that our move to Georgia will be postponed. At this point, we know we will have to wait at least through the first month and perhaps through the second or third month of treatment.

Praise the Lord for:
1. Wisdom to help James with today's pain.
2. A clear diagnosis.

Please pray with us for:
1. A definitive call from the MRI tomorrow--preferably confirming that there is no Leukemia in his Central Nervous System and that he will not need radiation treatment.
2. Continuing wisdom to treat James and yet keep him comfortable and as safe as we can.
3. Protection from infection.
4. Wisdom and timing for transferring James' care and our family to Georgia and wisdom to know how to handle the time between closing on our house (March 23) and moving.

Stephanie