Day 223 - We've had better days

     Evan and Cristy just completed another long day of appointments.  While it only consisted of meeting with two physicians the first appointment was at 7:40 off of North Druid Hills.  I wish I had better news to report.
     The first appointment was with the Immunologist that has recently taken Evan as his patient.  The Dr. reviewed his medical history and the results from the blood samples taken last month and spoke with Cristy about his findings.  Unfortunately he didn't feel there was anything in the blood to necessarily indicate a larger issue.  You might say, "Isn't that good news?".  Normally I would say yes.  However, Evan has had situations where his immune system was not responding to infections that were not related to chemotherapy suppression.  The Dr. agreed to consult with his peers and perform another blood draw for additional testing in the near future.
     He would also like to perform some genetic testing in an effort to find any possible immunological deficiencies. Typically, a problem with the immune system would be seen when the child is young, possibly in infancy, then continue throughout. The fact that Evan was a normal, healthy little boy before his cancer diagnosis does not coincide with this. There are cases of immunological issues associated with leukemia, but not typically with the kind he has. The genetic testing is a lengthy process, but may provide some possible answers.  
     Following this visit Evan and Cristy went to the mall to kill some time before heading to see the Orthopedic surgeon.  Another x-ray was performed and it showed a small amount of possible bone growth.  We were quite discouraged, although not surprised.  After all, he did just recently finish the toughest round of chemo.  With chemotherapy, it kills the bad and the good cells and the Dr. said it potentially could have affected his recovery.  He has since promptly scheduled us for a follow-up MRI next Tuesday.  This will give him a better idea of the growth and blood supply to the ankle, or if we're dealing with another problem here (AVN, Avascular Necrosis has been mentioned).
     These two set-backs could impact Evan's ability to attend school at all this year.  We're scheduled for the beginning of the next round of chemo on Monday and plan on consulting with the doctors about this.  Evan has undergone this round before and it didn't completely eliminate his immune system, but what we're finding is his immune system is anything but normal.  The suppressed immune system along with the need for his walker/wheel chair would be a difficult burden to place on the faculty at Hayes.
     Cristy and I are hopeful the days ahead will contain better news.  I should have more updates this weekend as Evan is scheduled for another blood draw on Friday.  If his counts are too low they'll suspend his chemo on Monday until his body is able to withstand the next chemical beating.