Fork in the Road

First, thank you again to everyone for all your prayers, messages, meals and various other ways you've supported the Lee family. We know that perhaps your prayers get the least "notice" as they are done privately, but they have the greatest power as our Lord in heaven hears and answers, and He is the one who holds all the power.

As Esther said, Ava will have another bone marrow biopsy next week. Up until this point, Ava has been going in to get chemotherapy on Thursdays, as she did earlier today. She also gets labs done each time, and her blasts remain at 0%. Keep in mind that these are "peripheral" blasts... meaning the blasts that are circulating in her blood. It's great that her numbers remain at zero and that her white count and ANC haven't really gone down, but the bone marrow biopsy will be more telling about what's happening at the source. You may recall that Ava's last bone marrow biopsy (post-AML therapy) revealed 0.7% blasts -- a great number, considering how high it was at the start and how high it persisted for so long after her first round of AML chemotherapy... but the docs still want to see a lower number.

The doctors want Ava's next bone marrow biopsy to reveal blasts of <0.01% in order for her to continue ALL treatment. Anything higher than that, they will switch her back to AML and be more aggressive about finding a bone marrow match. Bone marrow transplant is still the last resort, given that it's no walk in the park, even with a perfect match.

So we are nearing a fork in the road, if you will -- though this really has nothing to do with a "choice" about which route Ava will take. It hinges on the results of her bone marrow biopsy next week.

The two paths are completely different. If Ava's blasts are <0.01%, she will continue ALL treatment. This would be a HUGE blessing for a number of reasons:

• ALL is done on an outpatient basis (BIG PLUS!) This means she can be in and out on the same day, and chemo is a brief IV push through her line.
• ALL is so much better tolerated; no loss of appetite or weakness or feeling really crummy all around
• Outpatient treatment means Gwen gets to be with the family, too, and not feel passed around. There's much less disruption in family life.

Honestly, the drastic difference these last few weeks has given the Lees a chance to feel a sense of normalcy: Ava going back to school, Gwen starting school, just being able to do regular daily-life things. It's a deceptive sort of normalcy, because this cancer is always a cloud hanging over them, ready to throw them for a loop at any moment's notice. Yet it's been a welcome reprieve, given the turmoil of the first few weeks as you know, since you walked it with them. Even with this seeming normalcy, Ava is well aware of how different she is now from others.

How do you prepare for something like this? The ability to plan seems to be stripped away. If Ava continues ALL, perhaps they can plan other "regular life" things in this pseudo-normalcy. But if she switches to AML, it's going back to the hospital for who-knows-how-long, more ups-and-downs with labs, how Ava's response will be, possible platelet transfusions, figuring out how to coordinate life at the hospital... and needing to cancel/adjust the "regular life" things they were trying to plan before (though trying not to plan at the same time). How does one mentally and emotionally prepare for a bone marrow transplant? It seems to be two different worlds hanging on one numerical result.

Yet we know that God is still in control, and He is still good, no matter the outcome. Please pray for favorable results; Ava's complete healing; the peace of God to powerfully dwell in the hearts and minds of each Lee family member, that anxiety would not overtake them. Perhaps one of the blessings of finding ourselves where we have absolutely no control is resting in God's provision and seeing Him do immeasurably more than we ask or imagine.

Thank you again for your faithful prayers.