There are still a number of questions, variables and unknowns, so your prayers for God's wisdom and guidance are coveted in such a time. Here's what we do know:
- Ava has had a significant decrease in her MRD, but the fact remains that disease is still present. While her response to chemo has been positive, she really needs to be disease-free in order to go to transplant, and that is the doctors' aim. This second round of chemo is to see if she can reach remission (MRD negative) to set her up for transplant.
- Leukemia cutis can be very aggressive and hard to get rid of. The transplant team strongly advises that Ava also get skin radiation in addition to the chemo. It would be best for her to receive this radiation before going to transplant (vs. after transplant).
- Seattle is in the process of being able to provide radiation, but aren't currently able to provide that right now. So either way, Ava will get radiation in Chicago.
- Since Ava really wouldn’t be in any condition to travel after chemo starts, she is coming back to Chicago to receive both chemo & radiation.
The round of chemo runs 3.5 weeks or so, and radiation is close to 4 weeks. They don't want to do chemo and radiation consecutively (i.e. complete chemo first before doing radiation), because they run the risk of Ava's cancer growing unchecked without chemo during the 4 weeks she is getting radiation. This is risky if they want her to be disease-free before transplant. So, the thought/hope is that Ava can receive chemo and radiation concomitantly, at the same time.
However, it is unclear (to us) whether this is a good idea – can Ava's body take that kind of treatment? We don't know. It seems that all the doctors are a bit unsure as to the best treatment plan, so your prayers are especially appreciated and solicited!
What if Ava doesn’t reach remission after this round of treatment? What then? We don’t know. Should that happen, we'll have to reassess at that point.
Ideally, Ava would come back this weekend so she can be home briefly before starting chemo on Monday. However, last-minute airfare is really expensive right now, so Mike & Ava are scheduled to come home on Monday (4/4) and start chemo on Tuesday. Esther & the other kids will follow back home this coming Friday. Esther’s parents will fly back to Chicago in a couple of weeks.
Please pray:
- for God's wisdom and guiding hand to be revealed in the coming days/weeks regarding Ava's treatment and the timing and coordination of everything. May God's will be done, according to His ways, His timing, His wisdom, and for His glory.
- for smooth and safe travel back home for everyone
- for smooth and uneventful treatment here in Chicago
- for the abiding presence of His peace for the Lee family, despite the unexpected turns that may arise
- for Ava's complete healing, should the Lord choose
Again, we don't want to pigeonhole God in telling Him how we'd like Him to work. God is much more creative and awesome in the ways He can orchestrate His amazing grace and unfathomable love in our lives. We trust in His unwavering goodness toward us. It is also this amazing love that allows us to approach His throne of grace with confidence, asking and seeking His intervention and help at this time.
Thank you so much for your prayers! We cannot underscore enough how much of a blessing you have been to the Lee family.
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