Why Seattle?

A question was asked as to why Mike & Esther are looking at Seattle as a potential transplant location, and in case others are also wondering, here is my attempt to answer. (I apologize in advance if this answer is way longer than you anticipated, needed or desired!)

Seattle doesn't have anything to do with a donor's location. Thankfully, no donor has to travel to give marrow, nor does a recipient need to travel in order to receive it. It's merely to see which cancer center could offer Ava the best care. With a number of hospitals in the country that perform bone marrow transplants, Mike & Esther are interested in having the best team involved with Ava's transplant. (Remember that the actual survival rate after BMT is about 50-60%). The cancer center in Seattle has a good reputation/relatively high success rate with bone marrow transplants, which naturally makes them a good candidate to perform the transplant.

However, it's not that simple to determine which transplant team is the best. Of course there are stats like success rates that serve to be a report card of sorts. But each facility has their own philosophy of practice and how they would approach Ava's treatment, and Mike & Esther need to figure out which facility they prefer in terms of skill as well as philosophy. You've seen how there isn't a clear "right" or standard way to treat Ava's cancer - which drugs to use, when, etc. So Mike & Esther need to weigh the different approaches that each facility would take.

There are other factors to consider as well. Even if they determine that Seattle has the "best" team to perform the transplant, it isn't easy to uproot and move to the west coast for a possibly undetermined amount of time for treatment.

There are many variables to consider in the grand picture, so your prayers for wisdom are appreciated. Hopefully the meeting in Seattle will give answers to many questions and shed more light on what may lie ahead.

On the home front, Ava is clear to get chemo again (the methotrexate), so she will be admitted to get that tomorrow (Wednesday), then discharged when the drug clears her system. Then they'll get another bone marrow biopsy to see where Ava is at (this will possibly be next week, depending on how quickly Ava clears the drug and when her ANC starts rebounding). The biopsy results will also weigh in on which direction treatment will take.

Thank you again for all of your prayers. The support that has been offered up thus far really touches the Lees' hearts, and know that they are grateful for each part you have played. I know they would really like to thank each one of you individually and feel badly that they could never catch up on that. But know that your part has served a purpose, big or small, seen or unseen. Thanks for your willingness to serve as their community.