Monday,

Each day seems to bring a new twist to Bonnie’s ongoing battle with Leukemia. Today we received additional information on her overall treatment as well as a temporary change in course of action. First of all, as you can imagine, the amount of information and medical terminology that has been flying at us over the past four weeks has been overwhelming. It’s as if we have been trying to put together a 1000 piece jigsaw puzzle without the picture on the box as well as important pieces that are missing.

Today we found a critical piece of the puzzle that has been there all along, but just didn’t see it in the midst of the pile of pieces. We have been looking at various scenarios of “what ifs” depending on the outcome of the “next step”. What we thought was a bridge we may have to cross some day if the steps in between didn’t pan out, in reality is one that we will most likely cross in the near future – a bone marrow transplant. Somehow we misunderstood the overall diagnosis, thinking that a transplant would only come into play if the standard treatment we were following didn’t address the Leukemia. It really wasn’t a matter of “if” it is a matter of “when” the transplant will occur.

What we learned today is that Bonnie will have dormant leukemia cells that someday will rear their ugly heads and resurface. This could be in 4 months or 10 years, we just don’t know when it will occur. We do know though, it will occur and when it does, Bonnie would have to go through the entire chemo ordeal she is going through now before the transplant could take place. The other school of thought is to do it now once she is in this initial remission due to Bonnie being young. It hasn’t been totally determined as of yet, but the consensus seems to be do it now. Another reason to do it now is some of the follow up results of the cytogenetics studies that take a long time. One of the results of the cytogetnetics indicates that Bonnie would be more of a “4” on a 1 to 10 scale for good diagnosis, with 10 being the best and 1 being the worst. So this would be another reason to do the transplant now as opposed to waiting.

To complicate matters, Bonnie has a yeast infection in her blood and a possible infection in her colon. As we have previously mentioned, she has no immune system to fight these infections so the “Infectious Disease” team of physicians have been added to her case. They are aggressively going after these infections to contain them by tweaking and modifying the various antibiotics, antifungul and antiviral medications being run through Bonnie’s IVs. These infections were also the reason for the postponement of the bone marrow biopsy. As we mentioned yesterday they started to give Bonnie injections of Neupogen to promote the growth of white blood cells to help fight these infections. At this point the biopsy won’t occur until her WBC levels are at a normal range of 10,000 and we have been told that at this point the results will be skewed because of the introduction of the Neupogen.

One potential source of the infection is the triple lumen IV port that was surgically inserted into Bonnie the day after admission. This port is very convenient because of three picks for all the IV drips as well as blood draws for labs, as opposed to Bonnie always being poked for draws. Unfortunately they are going to remove this tonight and go back to a more typical peripheral IV pick on her hand or arm, which means they can’t use the food bag IV as the veins are smaller and difficult to push the nutrient fluid through them. We will find out on Tuesday if they will have her start eating again or use a less potent nutrient bag.

We realize this is probably more detailed than most of you reading this would want, but it is very difficult to summarize this in a few words which would create additional questions in your minds. Hopefully this will help you to understand what we mean by putting together a jigsaw puzzle without the picture and with pieces missing.

With all that said, we are still taking it one day at a time which helps us to manage the waves of information and change as they roll in. A dear friend gave Bonnie a wonderful 90 day devotional called Praying Through Cancer. Today’s title was “Firmly Held”. The writer shares a memory as a little girl wading out into the ocean with her father who held her hand firmly as the waves rolled in. She recalled that on occasion a wave would break over her head sweeping her off her feet, but her father would never let go of his grip on her. God doesn’t let go of His grip on us either. Isaiah 41:13 says:

For I, the LORD your God,
hold your right hand;
it is I who say to you, “Fear not,
I am the one who helps you.”

This verse and the commentary was a perfect word picture for Bonnie to dwell on throughout the day and helped her immensely to further know that her heavenly Father is there holding her hand as we continue to wrestle with the ebb and flow of her disease.

We appreciate each of you sustaining us through your prayers as we continue to trust God and His grip.