Update from Elaine

Dear Friends and Family,

What an incredibly long day. One that was bitter and sweet all wrapped up into one. Where to begin....

The MRI scan lasted appoximately two hours as anticipated.
~Praise for a really sweet radiology technician who encouraged Kate with smiles and kind words.

~Praise that Kate was able to be relaxed and calm throughout the duration of the long scan.

We were actually able to relax our anxious stomachs and eat lunch Kate chose Chinese- something we miss so much. She asked for two special dishes our "ayi" in China made the girls on a regular basis, but they weren't available.

MRI REPORT:
Kate's appointment with her oncologist was at 2:oo.
Dr. Jakacki was encouraged that the MRI scan looked very good. One angle of the MRI looked clear and showed the nodules were virtually gone. Dr. J indicated that from another angle of the MRI you could see a few residual nodules, but still significant shrinkage. This is why it is necessary for so many different angles or cuts to be made to assure a radiologist is getting a true picture.
~Praise: We prayed that we would recieve a positive report on the MRI -and Father answered with this affirming MRI scan.
~Praise: I was specifically praying about the brain involvement. The August 22 scan left a ? as to whether a "small" spot which has been there since surgery was changed or not. Because this spot did not reduce in size over the last 2 months of chemo, the doctor concluded that it must be scar tissue, as originally thought.

Treatment Plan:
Dr. J was encouraged that Kate's returned cancer was so "responsive " to chemo. We talked at length about the treatment approach. This will involve a higher dose of chemo and then a moderated approach of stem cell replacement.
She let Kate chooose the time frame as to whether to begin now or wait until after the holidays. Kate wants to get things started now. So next week she will be admitted to the hospital for a 2 1/2 day stay for the higher dose of chemo. This will drop her counts- particularly the WBC drastically. She will recieve daily injections of Nupogen for about 10 days following the chemo to help her WBC recover. At about 3 weeks following the chemo (just before Thanksgiving), Kate's stem cells should be ready to harvest. These will be removed from her arm via IV. This process usually takes about 4hrs and the amount of stem cells gathered will depend on Kate's body at that time. The collection could take place in 1 to 2 days or up to 1 week. The stem cells can be frozen and stored indefinitely.
~Our prayer is that the stem cells will flow easily and inplenty and be gathered in 1-2 days.

The plan is to put Kate on another dose of the VP 16 chemo for December and then begin the stem cell replacement in a tandem approach over the months of January, February, March. There may also be another period of full spine and radiation at the conclusion of the stem cell replacement treatment.

A Hard Question:
At the conclusion of our discussion with Dr. J, Kate looked at her and asked, "What is the life expectancy?" Dr. J replied, "with recurring medullo blastomas 9-12 months, but had the scan not been good tody, we might have been looking at 3 months."

This treatment plan provides quaility of life and may pust the envelope of the time frame to the far end of the 12 months or somewhat beyond. While we knew that with the recurrence of Kate's cancer that prognosis wasn't good, To have time parameters put on things made it more of a painful reality. Given this treatment approach the chances of a cure are not 0 but also not more than 10%.

Dr. J had the doctor in charge of the stem cell replacement come in and talk further with us. We finally laft the clinic at 5:00 with a huge amount of information to digest and a long, sad ride home. Kate and I cried some and when we reached my parents home Pappy held her while she cried. We returned home and she just wanted to cuddle with Maggie and me. I know that those of you who phoned will understand given the circumstances, my attention needed to be focused on the girls and not taking time from them to talk.
~Please ask for Kate's spirit to be encouraged and for God to infuse her with strength and courage to fight.

As I have encouraged Kate and Maggie... We know each day is a gift from God and he will give us the strength to live it with joy. We continue to ask God for a miracle. He alone knows the time he has written for each of our lives.

I have tried to explain things to the best of my understanding at this point. I will update when we have a time line for next week's treatment.

We are encouraged to know of the many people around the world that were covering us today with prayer. We are thankful for the positives and are clinging to God's grace and faithfulness for the journey ahead.

Only by grace,
Elaine