Mostly good news

James' appointment with Dr. Keller went well today. He said James' toxicity to this methotrexate would be class 4, on a scale of one to four. James is only getting a half dose of methotrexate compared to what other children his age and size would get. In another couple of months, James will get another run of three doses of methotrexate over a seven week period so Dr. Keller will look into ways we can lessen the toxicity for James without decreasing his dose further. One possibility is giving additional doses of the rescue drug leucovorin that James already gets after methotrexate.

James' counts were good and Dr. Keller hoped they would only improve over the next two weeks. His hemoglobin was a little low (7.7), but Dr. Keller felt like it would improve with the two weeks and decided we could pass on a transfusion today. I assured him that we would 'tank James up' with blackstrap molasses which should increase his hemoglobin. He actually came back with the recollection about reading about using blackstrap molasses to treat Crohn's disease--sorry, no details, that's as far as we got on that rabbit trail!

James' line flushed fine in the clinic, but his nurse couldn't get a blood return. We tried a more concentrated heparin, but that didn't help, so they put in the TPA, which is supposed to be more potent at busting up clots. Dr. Keller decided we should leave it in and I should try to pull it back tomorrow when I would usually flush his lines. PLEASE PRAY: that it pulls back with a good blood return and flushes just like it is supposed to.

The next chemo is scheduled for 5 July, so we have two whole weeks before we have to go back to the clinic or hospital, Lord willing. The plan is to go to Atlanta that Thursday morning, see Dr. Keller, get a spinal tap and chemo, then get vincristine by central line and start steroids again. We will have to stay the night in the area there (hopefully at the Ronald McDonald house) and return to the clinic on Friday to get two shots of Peg-Asparaginase. Hopefully, we will return home after that.

On the way home, Katie, James and I stopped at Walmart to do some shopping. James was a real trooper through everything and we could tell he was feeling better because he waved and said, "Aaahhh" to many folks in the store. When we arrived home, Hannah started doing some of James' cares and called to us for help because there was blood around his central line. To make a long story short, we talked to folks at the hospital, changed the dressing, cleaned the sight and called back to the hospital. It looks like everything is fine and a pulled stitch is the likely cause of the bleeding. We are still holding off on pulling out the TPA til tomorrow.

Looking forward to a boring day tomorrow, Lord willing.

Love, Stephanie