Praise God for His daily mercies.  Jeremy continues to be fever free, eating well, and energetic.

Praise God, Jeremy did not need a GCSF shot last Friday.  His labs looked good, his platelets are holding and his other cell counts went up.  We’ll see what his counts look like on Monday, when labs are drawn by our homecare nurse.

CMV is still positive.  The count is less than it was when it was discovered that it had reactivated, which is good news.  We continue to pray that it would not infect his eyes or lungs or any part of his body that could cause him harm.

Tuesday, 1/8 will be the first bone marrow aspirate post transplant.  From what I was told a while ago, the doctors will be checking remission and chimerism status.  Remission is achieved when there are less than 5% blasts in the marrow and a negative MRD (minimum residual disease).    Chimerism is a new term for us.  According to the hospital’s website, chimerism measures the state in which the donor cells have durably engrafted.  100% means that the cells being created/found in the marrow are from the donor.  Less than 100% means that Jeremy’s cells are still present.  We’re uncertain what they are expecting to see in this first aspirate.

The bone marrow aspirates have always been an anxious and emotional time for us.  In the past it would determine Jeremy’s remission status.  With a bone marrow transplant and this new chimerism measurement, we’re even more on edge.  What does it mean if he is not 100% engrafted? Does the presence of his cells affect his remission status? What if he is fully engrafted at this point? Is there such a thing as engrafting too fast? How will this affect the rest of his body?

In all these things, what can we do but pray and ask God to provide for Jeremy exactly what he needs? We pray for favorable results from the aspirate on Tuesday.  We pray for Jeremy’s full and complete healing and recovery.  God is good in all of this and we know that He works in this situation according to His will.

Praise God:

• He is good
• Jeremy is fever free
• Jeremy is eating
• Jeremy did not need that GCSF shot last Friday
• Jeremy’s counts continue to trend upward
• the CMV count has reduced

Please pray:

• that God would continue to use this situation for His glory
• that we would be obedient to God’s plans for this situation
• that we would continue to cast our worries and fears on the Lord, that we would fix our eyes on Him
• that we would continue to be reminded of God’s greatness and provision, that we would wait on Him, and that we would not allow fear to creep in
• that we would rejoice in the moments that God gives us
• that God would provide full and complete healing and total health for Jeremy, that the bone marrow transplant would be Jeremy’s final cure
• that Jeremy would not develop any late effects from the chemotherapy and drugs used to treat him, especially any second cancers
• that Jeremy would not have any brain, liver, lung, kidney, pancreatic, heart, or any other type of organ damage as a result of the chemo and antibiotics
• that God would protect Jeremy from any scrapes or bumps as his new marrow is not producing enough platelets yet to avoid transfusions
• that Jeremy would not experience any spontaneous bleeding from his nose, central line, or anywhere else on his body
• that the CMV would be eliminated from his system, that the CMV would not infect Jeremy’s lungs or cause any issues with his eyes
• that Jeremy would not encounter infections for fevers while he is home
• that Jeremy’s counts would start trending up more, especially his ANC, so that he will not need any more GCSF injections
• for Jeremy’s mental and emotional healing from the traumas he’s endured for the last 6 months and whatever he will have to face in the future
• that Alice and I would not get sick in order to care for our family
• that Matty would nurse easily and sleep well
• that Jeremy would maintain the desire to pray
• that God would give us the proper balance in caring for Jeremy and Matty

Please pray for the bone marrow transplant:

• that the donor cells would engraft, that Jeremy’s body would not reject the transplant
• that Jeremy would not encounter any graft vs. host disease, acute or chronic, especially anything severe or fatal
• that Jeremy would experience the maximum graft vs. leukemia effect, that cells produced by the new marrow would attack any cancerous cells
• that God would protect Jeremy’s skin, kidneys, liver, stomach, and intestines from both the donor cells and the medications used to treat and prevent gvhd
• that the mismatched blood type would not cause any issues for Jeremy

Please pray for our family and neighbors:

• for our neighbors in the bmt and oncology unit who are also enduring trials of their own, that they would find their comfort in Christ
• for our parents and families – that they would have rest and place their trust in Jesus and receive His comfort
• that we would be witnesses of God’s love and grace to our neighbors and the medical staff