Day 10, Wednesday, May 16th

More chemo today - asparginase. 

According to Wikipedia:  "The rationale behind asparaginase is that it takes advantage of the fact that ALL leukemic cells are unable to synthesize the non-essential amino acid asparagine, whereas normal cells are able to make their own asparagine; thus leukemic cells require high amount of asparagine. These leukemic cells depend on circulating asparagine. Asparaginase, however, catalyzes the conversion of L-asparagine to aspartic acid and ammonia. This deprives the leukemic cell of circulating asparagine."

Interestingly, the asparginase is produced by genetic modification to microbes - in this case, E coli.  Ryan got 5 shots in his thighs, of "E. coli" - actually the shots were of the enzyme asparginase, which was produced by E. Coli.

The Daily Numbers:  WBC 1500.  H&H (hemoglobin and hematocrit - measures of RBCs - normally around 12 & 36) is holding at 8 & 24.  Platelets "stable" at 21,000.  And no "bumps" in K (potassium) or Phosphate.  So far so good.

Part of me wants to jump for joy - we're killing off all those bad cells.  But with that comes susceptibility to infection.  I was worried about infections we might expose him to.  A valid concern, but the resident pointed out that the bigger risk are Ryan's own normal microbes - the normal bacteria and organisms like yeast that live in controlled levels on his skin and in his mouth and GI tract, but in the absence of normal protective immunity can cause serious infections. 

Ryan is actually doing quite well with all this.  Very queasy with odors - but his nausea has been able to be controlled with meds and he has been able to eat some crackers and some cereal & milk.

Sophia's mom flew in tonight - she's terrified of flying, but overcame her fears to be with Sophia.  Everybody slept at home since Ryan felt he needed some alone time and wants to start drawing.  Art has always been his passion and his release.  I took his drawing table into the hospital, but it doesn't collapse easily, and takes up a lot of room.  I'll have to work on a smaller collapsible table, or maybe an easel.

We've been at this for 10 days now, and it's starting to feel "normal" - whatever that is.  Daily runs to the hospital.  Trying to figure out how to help Ryan, when in reality all any of us can do is stand idly by feeling useless.  But I remind myself that mental state is 90% of the battle here, and that's where we can help Ryan.  So I focus on doing what I can to help Ryan, doing laundry, getting supper on the table, getting the girls to do their homework, piano, flute, etc.  Chauffeuring the girls to dance, Tae Kwon Do and basketball practice.  Mindless routines bring a sort of comfort - deluding my heart into thinking there is something left in our lives resembling normal.

And praying.  It's amazing how close the Savior feels at times like this.  I can't begin to express my gratitude for His comfort.  Little blessings - tender mercies -  as so sweet.

The day of  fasting and prayer for Ryan will be held on Sunday, May 20th.  We invite all to join us at whatever level suits your personal spirituality.  We firmly believe that God answers prayers and that, ultimately, only He can cure Ryan. 

Additionally, we are mindful of His hand in guiding the wonderful people whose sacrifice and skills will give Ryan the chance to conquer this.  As a physician, I often have felt cynical and disappointed in myself and my colleagues - I was burned out when I left medicine.  But I can honestly say I have never been prouder of my profession.  When I think of the hours of study and sacrifice that those caring for Ryan have collectively made to serve others, I am quite humbled and immensely appreciative.

---Barb