Praise God, day +3 and +4 have been mostly uneventful.  Jeremy continues to eat and be fever free.

Yesterday, day +3, Jeremy started a chemo called methotrexate.  It is intended to prevent graft vs. host disease.  He’ll be getting this chemo on days +3, +6, and +11.  Although it’s a much smaller dose than the chemo he’s gotten in the past, it comes with the same side effects – nausea, vomiting, mucousitis.

He has also been getting a chemo called cyclosporin, also intended to prevent gvhd.  With this one, though, it will be every day, the first day being day 0.  It goes in very slowly, but again, has the same side effects as the other chemotherapies.  For now it is IV, but he will be going home with it and will need to take it orally.  We don’t know yet how long he will need to be on it.

We were reminded yesterday that the first bone marrow aspirate will be on day +30, to check engraftment status.  Each bone marrow aspirate (there will be at least 3) will be to see how much of the donor cells are in there compared to Jeremy’s cells.  The doctors are expecting, of course, to see more donor cells than Jeremy cells.  Full engraftment can take up to a year.

Praise God, we were told today that the blood cultures done from day 0 continue to be negative.  Additionally, his liver and kidneys are looking better, too.

The doctors come in every day expecting Jeremy to be feeling less and less well.  Mucousitis tends to set in around now, progressively getting worse over seven or so days.  Today, we noticed that Jeremy had coughed a few times, nothing persistent, gagged a few times, and complained once of belly pains while on the potty.  Praise God, Jeremy still ate and drank well today.  We are praying that Jeremy will not encounter mucousitis and will be able to eat and drink during his entire stay in the hospital.

Praise God, Jeremy’s sleeping has gotten better, too.  He’s been going to bed earlier and earlier the last few nights.  He’s pretty much potty trained at this point.  I can count on one hand the number of messy diapers we’ve had since we’ve been admitted.  The doctors ordered a lot of fluids for him since day 0, so the last two nights, he’s been waking himself up throughout the night to go potty.  I’m impressed, and I guess this sounds weird, but I wouldn’t mind if he peed in his diaper instead of waking himself up, so he would get more uninterrupted sleep.

Praise God, Jeremy continues to be playful and in good spirits.  He laughs at our funny faces and the silly things that happens throughout the day.  A paper cup falling on the ground can yield a good two minutes of laughter.

We continue to daily lift this entire situation to our Father in heaven, who hears our cries for mercy.

Praise God:

• for His daily mercies
• Jeremy continues to be fever free
• Jeremy ate well today
• the blood cultures continue to be negative
• Jeremy’s kidney and liver numbers are looking better
• Jeremy continues to be playful
• Jeremy has been sleeping earlier
• Jeremy no longer has any congestion or runny nose
• Alice and I continue to be in good health in order to care for our boys
• Jeremy did well with the ATG

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 God would protect Jeremy from any scrapes or bumps
• that Alice and I would not get sick in order to care for our family
• that Matty would nurse easily and sleep well
• that God would give us wisdom in teaching Jeremy in the hospital environment
• that we would extend Jeremy an extra portion of patience and grace as we try to care for him with the added hyperactivity
• that we would adjust well to the new challenges of being in the BMT unit, with all it’s necessary rules and regulations

Please pray for the conditioning chemo regimen:

• that it would be effective in destroying any lingering cancer cells
• that Jeremy would not encounter any mucousitis (mouth, GI tract sores) that would prevent him from eating or drinking
• that Jeremy would not encounter any fevers during the neutropenic period
• 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 Jeremy would not encounter any c-diff as a result of the antibiotics
• that Jeremy’s liver numbers would continue to stabilize and the chemotherapies would not cause additional damage to his liver
• that Jeremy would not need to be admitted to the PICU at any point during the chemo regimen or bone marrow transplant
• that Alice, Matthew, and myself would not be harmed by the chemo we might come in contact with when changing Jeremy’s diapers

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 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
• that Jeremy would not experience any severe or dangerous infections from the transplant
• that the prophylactic antibiotics would be effective in treating the bacterium in the donor marrow

Please pray for our family and neighbors:

• for our neighbors who are also enduring trials of their own, that they would find their comfort in Christ
• for our parents – 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