More Quiet Days

            David continues to be in good spirits. Xiomara and Andrew arrived yesterday from the Bronx via Megabus; Peter and R’el will drive here this evening. Tomorrow, David, Jim, and I will give talks at our Arlington ward. You’re all invited: sacrament meeting starts at 2:00 p.m. This is a serious invitation: Arlington Ward meets at 2:00 p.m. at The Church of Jesus Christ of Latter-day Saints, 15 Ledgewood Place, Belmont, MA, just down the hill from the Boston Temple.

            David continues to go to Mass General for bloodwork twice a week. This Thursday, November 20, will be the 28^th day of his Phase 1 cabozantinib drug trial. He’ll have a bone marrow biopsy to assess the efficacy of the treatment so far. The semiweekly blood tests show what percentage of his white blood cells are leukemic blasts, but with the bone marrow biopsy they can actually analyze and assess the bone marrow, where all the blood cells develop.

            Here’s the chart of his white blood cell count. Although a normal WBC is 10, the important information is whether the white blood cells are normal, mature cells or immature (leukemic or cancerous) blasts. So, we want the white blood cell count to be between 4 and 10, but only if most of those cells are normal, with a low percentage of blasts. It’s still too early to know what effect, if any, the cabozantinib is having: sometimes with these experimental drugs the blast percentage increases initially, then decreases. We’ll have to just wait and see.

Date	White Blood Cell Count	Percentage Blasts
6-Oct-14	2.2	2.60%
10-Oct-14	2.7	8%
15-Oct-14	3	9.20%
23-Oct-14	15.7	47%
24-Oct-14	14.9	53%
26-Oct-14	15.5	65%
30-Oct-14	8.81	55%
2-Nov-14	6.68	33%
5-Nov-14	4.8	39%
10-Nov-14	7.29	29%
13-Nov-14	8.73	46%

            David asked Dr. Fathi this week whether his prognosis has changed. Dr. Fathi said that the prognosis hasn’t changed: David may feel good as long as the treatment can keep the blast count down. However, there is no expectation of a cure at this point.

            I do believe in miracles, but as a friend wisely remarked, “To be a miracle, it has to be rare, right?” We pray for that rare outcome and give thanks for each day of mortal life.