Simon is such a little trooper--a real inspiration. I hope you and Simon
have a peaceful weekend, and he continues to feel good and happy. I love
it that he's even surprised the oncologist.
much love and big hugs to you both, Kerry

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
Behalf Of [EMAIL PROTECTED]
Sent: Thursday, January 13, 2005 7:30 PM
To: [email protected]
Subject: Simon got chemo today


I took Simon to the oncologist and the news was mixed. On the very good
side, 
his bilirubin was down from over 9 to only 2.3!  This is still almost
three 
times normal, but quite a drop, and enough of a drop to safely give him
the 
full dose of CCNU.  Because it seems likely that the heavy doses of
steroids he 
got last weekend (and your prayers!) killed off enough lymphoma to bring
the 
bilirubin down and make him feel good (more on that later), he also got
a dex 
shot with the CCNU.

The bad news is that his PCV was down to 11 on the machine reading and 9
on 
the hand reading (the latter of which is supposed to be more accurate).
The 
oncologist suggesting transfusing him again, but I decided not to
because it 
only raised his PCV by one or two points in the past and because,
probably due to 
the steroids (and your prayers!), he is feeling much better than when he

needed transfusions in the past. And I had promised him I would not
leave him 
there.  The oncologist agreed this was fine, that you transfuse the
patient and 
not the number, and that as long as he is bright we can try to ride it
out or I 
can bring him in for a transfusion later.  We discussed Epogen again and

decided not to put him on it. The reason is this:  Simon's anemia is
regenerative-- 
he is still making red blood cells-- but the problem is that the
lymphoma has 
taken over so much of his bone marrow that he has little bone marrow
left to 
make the red blood cells with and so makes many fewer.  When the
lymphoma is 
killed off, his bone marrow bounced back. When he responded to chemo 
previously, he went from a PCV of 11 to one of 33 in two weeks.  If we
can kill enough 
lymphoma, with the chemo and/or steroids, his bone marrow should bounce
back 
again on its own. If we can not kill enough lymphoma, the Epogen will
not save 
him because the lymphoma will take over all of the bone marrow.  And he
seems 
so much better on fewer medicines that I really do not want to keep
adding 
things to his little body that do not have a high probability of helping
him 
(granted, the CCNU does not have a high probability of helping, but if
it does it 
will take care of the root problem which the Epogen would not).

The oncologist was rather surprised to be treating Simon again. When I
asked 
him to give me a probability of the chances that CCNU will help Simon,
he said 
"all bets are off with Simon. I'm not going to try to predict anything
with 
him anymore."

Simon is very far from out of the woods, and his PCV is obviously a big 
worry.  But I am going to try to treat him like a love bug, rather than
a number, 
and just be glad he is feeling so good and happy while he is.

Thanks for all your prayers (and please keep them coming!),
Michelle

P.S. We took a bunch of pictures yesterday and today of simon looking
really 
silly and cute, laying on his back for belly rubs and looking and
Buddhas, and 
wanted to share them with you because you all have been so involved with
his 
story.  However, I tried a way of posting them for free on the web but
it did 
not work (photobucket). If anyone knows of a different way I can do that
and 
send you the link, I will.  

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