Day 29

Sorry this has taken me so long to write.  It's 9:45pm and Ari is still jumping up and down in his crib. 

The results of the bone marrow biopsy first...(I preface this by saying these are preliminary results. Final results will be available Thursday.)

The good news - There was no cancer in the bone marrow aspirate visible under the microscope. (The bone marrow itself has not been tested. This takes 48 hours.  There is a chance final results could differ from the prelim.)

The so-so news - There wasn't much going on in the bone marrow (no bad cells, not many good cells) because the bone marrow is still recovering from all of the treatment. This means (and we knew this already) that we have to wait for Ari's blood counts to rise to normal levels before we can re-test and be sure that the bone marrow is producing only good cells and no bad cells.  Because his blood counts weren't high enough to start, we knew that it was impossible for today's results to be conclusive.

The bad news - There isn't any. (Well, I guess the bad news is we have to wait at least a week before starting phase 2 of treatment. And we'll be waiting in room 616B.)

I'll explain in further detail at the bottom of this post if you want more info.

In addition to the BM biopsy, Ari had a CT scan today to look again at his chest.  Our doctor told us to expect the mass would be around 10-15% of the size it was 29 days ago and that would be normal.  Guess how much of the mass remained?  0%!  I'm not quite sure what's going on in these photos (there are organs and bowels and stuff), but what I do know is the photo on the left (from June 4) is very bad and the one on the right (today) is healthy and clear and cancer-free.

 
We feel good about the results of both tests.  Though things are still uncertain, today's results could have been drastically different.  The reason they did the test knowing his levels had not yet recovered was to check for visible cancer because that would have changed his treatment plan.  They didn't see any.  And we are so thankful for the news we received.

I don't have the energy or creativity to write about anything else tonight.  Oh, and now it's 9:54pm and Ari is asking for bubbles and pretzels and pointing out all of his body parts on himself and on his animals and Elmo stuffies.  And he did not take a nap today.  Will he ever fall asleep?

I'll leave you with a photo of how we passed the time while we waited for Ari to come out of the OR this morning.  This accurately described my mood all day as we waited anxiously for the test results:

Additional information:

In order for Ari to be in "remission", he needs no cancer in the blood, no cancer in the spinal fluid, and no cancer in the bone marrow. And, his white blood cells and his neutrophils (and a bunch of other stuff like red blood cells, platelets, etc) all must be at normal person functioning levels.  What we know now is that the chemo worked well and that it appears as though there is no cancer visible in his body.  However, now we have to make sure his bone marrow produces healthy cells and not cancer cells.  There's always a chance that the chemo got rid of the cancer, but that the body will produce it again.

The current plan is to wait a week, give a "holding dose" of a chemo drug that has no side effects (except constipation) hope his levels rise, and re-test the bone marrow.   If one week is not enough time for the levels to rise, they will wait 2 weeks. The doctors have assured us every kid recovers at a different pace and we just have to wait and see how Ari's body responds to the medication being out of his system and how his bone marrow now responds to new cell production.