The blood cultures done when Jeremy hit his fever came back positive for a type of bacteria – strep viridans, I believe.  Turns out this is the reason for his fever.  The docs tell us that it’s very common with AML patients, given their counts are so low.  The antibiotics (tobramycin, vancomycin, zosyn) he’s currently on covers this type of infection.  Over the last few days, after discovering the bacterial source of his infection, they’ve been able to remove the tobramycin, but had to increase the dose of the more toxic vancomycin.  To protect his kidneys, they increased his fluids as well.  We’ve had a rough few nights because of it, getting up to change his diaper (and his pajamas) frequently.

There was also talk that if the line is infected with too much bacteria, that they may need to take the central line out.  We’re not sure what this means just yet – if they take it out, when will they put another in, etc.  Taking the line out and putting another one in would be a surgical procedure and in his neutropenic state and low platelets sounds risky to us.  We’re told that it’s rare.

They discovered earlier today that the bacteria is sensitive to the less toxic zosyn and would be able to discontinue the vancomycin and turn his fluids back down later tonight.  Unfortunately, he hit another fever tonight and they will have to start the three antibiotics again and do blood cultures.  We’re really not sure what it means that the fever has been somewhat persistent.  At best he will need to stay on the antibiotics and at worse, they will need to take out the line.  We are praying that it will not come to taking the line out.

Praise God that the skin biopsy results didn’t show any new bacterial infection.  Apparently, the skin sample they had taken was too small, so they weren’t actually able to culture it.  But, they were able to see that a clot had formed and in that clot were signs of bacteria.  They were unable to speciate the bacteria, though, so they are making the assumption that the cause of these bumps was the same that caused his fevers.  A large part of me wonders, then, if the biopsy was even necessary.  I guess in these types of situations it’s better safe, than sorry.

We’ve also seen three more red bumps on his skin.  Normally there wouldn’t be too much concern considering there are only a few of them, but given the information we got the other day we’re a bit anxious about what they could be.  We are praying that these spots would fade with the antibiotics, that there is no persistent infection, and that Jeremy won’t need anymore skin biopsies.

For Jeremy, the last few days after the skin biopsy have been progressively getting better.  He didn’t feel like eating too much the day of or the day after.  The fever and the skin biopsy made him pretty uncomfortable.  Still, even through the fever and the recent skin biopsy, he managed to smile and dance.  We thank God that He gives Jeremy the strength to endure.

Jeremy does tell us occasionally that his leg “stings” where the “bandon” is, but he just powers through it.  We praise God everyday for blessing us with such a vibrant, energetic child and we are often reminded of God’s sustaining hand on Jeremy.  We try to get Jeremy to take it easy on that leg, but he is 2, after all, and it’s impossible to ask a 2 year old to sit still.  He stands on it, jumps on it, and planks on it.

Jeremy’s also been very wary of any doctors he hasn’t seen before, batting away hands that try to touch him.  It’s hard to blame him for being protective of himself.  The skin biopsy episode is still very fresh in his mind, and ours.

For us it’s still been emotional.  After the biopsy, we held him and tearfully apologized to him over and over again, telling him how sorry we are that he has to endure this trial.  Yesterday, Jeremy kept apologizing to us, “Mommy, Daddy, sorry poking leg.”  While he may just be mimicking us in our apology to him, it just broke our hearts to think that Jeremy might have felt it was his fault that he had to have that biopsy, that “poke.”  Our prayers often bring us to tears as we ask God to heal every affliction that falls on Jeremy.

Praise God:

• for the fellowship of Christ who continues to cover Jeremy in prayer
• that the skin biopsy results didn’t show any new infections
• that Jeremy will not need the more toxic antibiotics
• that Jeremy has been eating
• that Jeremy is recovering well from the skin biopsy
• that Alice and I continue to be in good health

Please pray (new/updated items in bold):

• 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 God would provide full and complete healing and total health for Jeremy
• that God would sustain Jeremy through this block of treatment
• that Jeremy’s bone marrow aspirate at the end of this block of treatment would show < 5% blasts (leukemia cells) in his bone marrow and negative MRD (minimum residual disease)
• that God would provide with the whole process of finding a bone marrow match, the risks of transplant, and the anxiety of it achieving long-term remission for Jeremy
• that word would continue to get out about the need for a perfect bone marrow match and that one would be found for Jeremy
• that Jeremy’s little brother would be a match and that there would be a sufficient volume of cells in the cord blood to qualify for a good transplant
• that God would give Jeremy an extra portion of His strength for this block of treatment
• that we would not encounter any side effects that would affect his appetite – nausea, vomiting, mouth sores and that Jeremy would have a good appetite throughout the entire block of treatment
• that Jeremy would not experience any more stomach pains
• that Jeremy would not encounter any life threatening side effects
• 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
• that God would protect Jeremy’s heart with the new medication (mitoxantrone)
• that Jeremy would not encounter any more fevers due to bacterial, fungal, or yeast infections, especially in his neutropenic state
• that the antibiotics will be effective and that the line infection Jeremy has will clear up quickly
• that there wouldn’t be any more line infections and that we wouldn’t need to replace it at any point during Jeremy’s treatments
• that God would protect Jeremy’s kidneys and liver as they process the antibiotics coursing through his system
• that fevers Jeremy does encounter would subside quickly
• that Jeremy skin biopsy site would heal quickly and would not cause too much pain or discomfort
• that God would relieve Jeremy of the traumatic stress of the skin biopsy procedure
• that the skin bumps would not be a result of any additional infections
• that God would continue protect Jeremy’s central line and there would be no infections as a result of it
• that Jeremy would sleep better at night
• that we would continue to be reminded of God’s greatness and provision and that we would not allow fear to creep in
• that Alice and I would not get sick in order to care for Jeremy
• that God would protect Alice and baby brother from all the emotional stress
• that baby brother would be full term before deciding that he wants out
• for our neighbors who are also enduring trials of their own