Febuary 2006

Feb. 28, 2006

Hello Everyone,

Gabriel is very active and playful. His platelets where low which required a platelet transfusion. Platelets help to clot our blood if we are cut, receive shots, etc. They also help prevent bruises from falls. A normal platelet count for a kid his age is 130 to 450 (or 130,000 to 450,00). His count yesterday was 7. His hemoglobin was 8.9 (normal is 11 - 15) showing the transfusion last week helped because his hemo may have gone lower. His white blood cell counts where 1.6 (normal 5-11). WB is where infection fighting cells are located. He, at this point in therapy, has become neutropenic or he has neutropenia. They expect his counts to drop more which is normal for a child during this phase. His monocytes , however, where high which is an indicator his counts will begin to recover and he has already experienced his low point in this phase.

Neutropenia is an abnormally small number of infection fighting cells (called neutrophilis) in the blood. Leukemia patients often experience this side effect throughout therapy. Because his infection fighting cells are low he has to monitored carefully, set apart from crowds or others that are sick, and everything needs to be kept sanitized to prevent any type of infection.

I mentioned that neutropenia is normal for leukemia patients throughout therapy. Here a visual picture of why it is normal. Chemotherapy is a treatment to kill cancer cells in the blood. When Gabriel was diagnosed his cancer cells were 90 of every 100. During the induction phase of his therapy (the first 28 days) the chemo blasted a lot of the cancer which is when he went through "remission." As the chemo blasts the cancer cells they also kill other blood cells. One of which are the infection fighting cells. Every week of therapy his blood work is checked to see where his counts are. In a way a person can look at experiencing neutropenia as 'the chemo is working.' That is one reason why low counts are normal.

Before I continue I want everyone to understand whenever I mention remission as of now it does not mean cured. It simply means the cancer cells no longer elevated high enough to be seen in the bone marrow. For instance when he was diagnosed there may have been trillions of cancer cells in his blood, during his remission those cells may have dropped to the millions even thousands. Still existing and able to reproduce, this is why the chemo must continue. This cancer for him requires 3 1/3 years treatment before it is cured completely. Gabriel will experience remissions throughout this therapy as well as relapses. I am encouraged that he is already cured. We are simply "going through the motions" for Gabriel's testimony.

Different chemo medicines work to cure him in different ways. It's tough hearing "Gabriel is on very intensive Chemo, we in fact expect his counts to be even lower." But I love hearing "Gabriel is responding very well to this intensive chemo. Kids don't usually respond this well to his chemo." If you where to see Gabriel in action you would assume nothing was wrong with him. He has lost a lot of hair in the back of his head, has a couple bruises from low platelets and a rash on his face from the chemo. Otherwise he looks very healthy and has a good appetite. Gabriel has started to vocalize more. He loves wrestling and tickling Justin.

Prayer request: Pray that God will give me insight on his protocol for the next phase. When his records where sent to MUSC the
package I was given (showing every phase and medicines/chemos given during that phase for the next 3 years) is different from the package the doctors where given. He will start the new phase in two weeks. I don't know what medicines he needs right now for chemo, but God knows. I need wisdom. I have indicated to the doctors my concern and they are researching what is the correct protocol (mine or theirs). Meanwhile I will contact Children's Hospital of Michigan to give me answers.

Thank you all for your prayers. If this email had too much info please email me back "Angela that was too much, just give me the basics." I've learned much and I know this is a lot. Everything I've written is what I have learned (I didn't copy the info from a website Steve haha.) Please email any questions or concerns (esp. Nana and Oma).

Angela