May the Lord answer you when you are in distress;
may the name of the God of Jacob protect you.
May he send you help from the sanctuary
and grant you support from Zion.
May he remember all your sacrifices
and accept your burnt offerings.
May he give you the desire of your heart
and make all your plans succeed.
May we shout for joy over your victory
and lift up our banners in the name of our God.

May the Lord grant all your requests.

Now this I know:
The Lord gives victory to his anointed.
He answers him from his heavenly sanctuary
with the victorious power of his right hand.
Some trust in chariots and some in horses,
but we trust in the name of the Lord our God.
They are brought to their knees and fall,
but we rise up and stand firm.
Lord, give victory to the king!
Answer us when we call!

I began praying the Psalm as I read it.  Yes Lord, answer me in my distress!  Yes, Father, send me help from your sanctuary.  My heart echoed the words of the Psalm and then I read the words, “may he give you the desire of your heart, and make all your plans succeed.”  Okay, Lord, yes, yes, that would be lovely, glorious, but I know your ways are higher than my ways and my plans, and the desires of my heart may not be what you have for me right now.  I continued to read through the Psalm and pray its words but I thought, God, you taunt me.  Victory?  Victory?  How can I hope for such?  Why did I have to read this Psalm right now, of all the Psalms to read, I just don’t know how this is going to help me bear the weight of hard news.  “Some trust in chariots and some in horses, but we trust in the name of our God.”  Yes.  Yes.  I trust you Father, that you are able to bring healing.  My ultimate hope is in you for Allistaire’s life.  Yes, Father, I trust you in the face of her possible death.  My hope is not in my own strength to cope with sorrow or make sense of why you would allow such woe – I put my hope in you, I entrust my heart and my life to you.

The phone rings and it is Dr. Pollard calling from her twin boys swim lessons.  “It’s all good,” she says.  The Flow Cytometry is good, no detectable cancer.  “It’s all good,” I yell down the hallway.  And I laugh and I think on the words of that Psalm and I am humbled by the mercy God has shown me this day.  Mercy.  So many times it has felt like we are walking to the gallows or her sweet head lays below the guillotine, and then we are led away from that death.  Life has been sustained once again.  Oh Father.  Thank you is so utterly insufficient.

The week continued thus on, with an appointment with GVHD guru, Dr. Carpenter, at SCCA on Wednesday.  I think his words were, “she looks like a million bucks.”  I’m so sad I missed the open door to correct him, “actually four million bucks!”  He was absolutely pleased with how she is doing.  Without me even knowing it he was examining her.  “Her skin looks great, her hair looks great, her nails look great.”  No, he’s not a beauty expert but knows how to spy the signs of GVHD.  It was decided that because their clinic schedule is on a 6 week rotation and Allistaire’s chemo is every 4 weeks, rather than coming to Seattle twice a month, he felt comfortable in having Dr.Pollard look for any GVHD concerns at the beginning of her next course of chemo, and then being seen with him at SCCA the following month.  The goal is to taper her Beclomethasone which is the steroid for her gut and it that goes well, a few weeks later, begin further tapering her systemic steroid, prednisone.  Ideally, Allistaire would be completely off all immune suppression/steroids, either prior or in conjunction with the end of her rounds of chemo.  The idea is that if she is no longer receiving the opposition of chemo to her cancer, she needs the maximum effect of her immune system (Graft Versus Leukemia), to give her the best shot at staying in remission.  In consulting with Dr. Scott Baker, who has the most experience with Azacitadine (though in the adult setting), his recommendation is to plan for 6 rounds if there is still no evidence of disease at any point.  She has received 4 rounds so far and so conceivably could only need the December and January rounds.

Even with the good news and the beginning of chemo on time, I still felt hesitant in my joy, knowing that we were still waiting for cytogenetics and chimerism results.  The cytogenetics are normal – there is no evidence of the MLL-rearrangent that has been the marker of Allistaire’s disease.  The chimerism results show 100% donor.  This time the sample was taken from her marrow rather than the peripheral blood.  If something were awry, it would seem likely that it would show in her marrow first.  One hundred percent donor!  Walls toppling again.

As always, I am now wise enough to know that these results are for the day and the tests are imperfect, but nevertheless, there is SO MUCH to be thankful for!!!!  I ran into Dr. Rosenberg, our first attending with Allistaire’s relapse.  She said she heard Allistaire was doing great.  I was hesitant.  She said to me that I should say she is doing great with such great news of her flow cytometry.  I was hesitant.  Later that evening I found out that little Christian died last week.  Christian also had AML.  He was diagnosed a few months after Allistaire and relapsed a few months after her.  He had a transplant about a month after her.  His family packed up and moved out of Ron Don the very same day Allistaire and I did.  Despite the language barrier, I saw the joy on their faces.  They were going home with their boy.  It seemed all was well.  That was only a month ago.  Christian is dead.  I don’t know any detail and my mind cannot fathom it.  I saw Dr. Rosenberg again a few days later and told her she was right, I should say Allistaire is doing great.  The doctors and nurses, they have seen so many times seen the suffering and death that can be the reality.  They see Allistaire in contrast to that.  I look at Allistaire and I hope for a normal life for her; I look at her in contrast to “normal” three and a half year olds.  Doctors will talk to you of “quality time,” and the truth is I want to scream in their faces that I am not interested in quality time – I want quantity – I want a life time for my child!  I know they are only speaking as they must and are speaking according to their body of experience with countless children.  I don’t scream.  I just nod my head.

Father, thank you for quality time.  Thank you that my child looks like a million bucks.  Thank you that Allistaire’s energy surpasses that of nearly everyone I know.  Eating is a phenomenal struggle. It has been an epic battle but I pray as we get farther from chemo, it’ll get a little better again.  She actually gained a little weight, up from 16.3 kg to 16.6 in a week.  Another victory, another gift.  Our hosts from this past week and a half have offered their home again for Allistaire’s December course of chemo that should start the 23rd.  More provision, more bounty.

Remember in elementary school the cheesy thin cardboard images the teachers would festoon the room with for each holiday?  For thanksgiving there were always turkeys and pilgrims and that weird conical basket with various fruits tumbling out of it.  “The Cornucopia, or horn of plenty, is a symbol of abundance and nourishment, commonly a large horn-shaped container overflowing with produce, flowers, nuts, other edibles, or wealth in some form.”  Yes, I’m excited to move onto Christmas, but I would be utterly remiss, if I did not speak of God’s provision of overwhelming abundance – of extravagant wealth, of unmerited mercy, of love that I hear spoken to me not with my ears.  Thank you Father above and Holy Spirit indwelling.  Thank you Christ who in your death and resurrection, overcame sin and death.  Thank you for bounty, both inwardly and outwardly.  Thank you for this day, the day the Lord has made.  I will rejoice and be glad in it!