Jacob has improved steadily these past few days. The oscillator settings keep going down, and he's reduced in size with the help of diaretics (i.e. it's been a busy week in the pee bag). We're hoping to transition onto a standard ventilator in the next week. We hope his lungs continue to heal.
Chemo started yesterday. Day 1 was just the Ara-C. Today was both the 2-CDA and the Ara-C. This will be the case for days 2,3,4 & 5. Day 6 will be 2-CDA only and then a month off until round two. During recovery we will expect Jacob to have high fevers and erratic blood counts...both standard side effects of the chemo. He is holding steady at 99ish for his temp so we're encouraged that the fevers haven't started in yet. If there are any positives to draw from his being unconscious, it's mostly the fact that he doesn't have to experience the nausea and pain (joints, headaches) that are also standard with this treatment. His hemoglobin and platelet levels are good today (he got a red cell transfusion last night), which puts his body in a good state to receive the chemo. Now we just sit and wait for the treatment to work.
Over the next couple of weeks the encologists will be looking for reduction in the size of Jacob's liver and spleen. Other than feeling the size difference in his belly, we will notice changes in his body chemistry that help us determine that this is happening. His hemoglobin and albumin levels should be able to hold for a longer period of time before dropping (we are used to these drops because of the increase in the size of his liver & spleen in recent months). Meanwhile the PICU team will transfuse as necessary with blood, platelets, and albumin to correct the effects of the chemo on his body. As marrow begins to rebuild his body chemistry, it will do so without the LCH cells, and in turn will improve his health, moving him further away from the problems brought on by the LCH.
Soon we will update you on this vast team of people working on Jacob. It's an incredible team, and we're blessed to have them in Jacob's life.
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