Here we are

So Joshua's lumbar puncture, which represented the last element of his first round of chemo, went smoothly. He went into theatre about 1.00pm, and we were discharged about 3.00pm. The good news is that we are now free from hospital shackles until Friday when we need to go in for a blood test and specialist appointment.

 In theory, Joshua should now be an outpatient for two more weeks, when his next round of chemo is due (around 13th September.) The expectation of the doctors, however, is that some time in this period Joshua will need to be admitted for treatment of the chemo side effects (most likely severe mouth ulcers, or some form of infection due to his lowered immunity). We would appreciate prayer that Joshua will confound their expectations!

In case I haven't given the 'big picture' treatment plan, it is this: four rounds of chemo, after a one week 'pre-phase'. Each round of chemo is 5-7 days, and follows approximately 21 days after the start of the last. This means an approximate two-week period for recovery between each round. The expectation is that after the first round subsequent rounds may well be delayed due to complications - i.e. infection or excessively low blood counts. Blood counts have to recover to a certain level before they can commence the next round. Again, another point for prayer.

The first two rounds are the same mix of drugs, and the latter two are also the same. In between Joshua is taking various pills to combat potential side effects. We also have four fridge magnets with the signs of infection or complication that we need to watch out for. Should these arise we have to go straight to the hospital. In case you are interested:

So now we are trying to work out what the 'new normal' looks like.

Those of you with the time and good maths may have worked out that the best case is that Joshua will be finished with his treatment around the end of November. However, we have been told to expect delays, so we are not counting any chickens quite yet. We are all missing Cairns though, so will be quite happy to come home when they let Joshua go. Even after we return we can expect that Joshua will be under medical supervision for some time. The general lowered immunity is expected to last for at least six months after treatment is completed.

The other positive thing is that the school have said that Ruben can attend prep. He seems keen, but we will see how he feels about it tomorrow...(He is actually mainly keen to go in the school taxi 'with the big kids'. We have said that Mummy has to come with him, at least on the first day...)