Julia Update

Hello Everyone,

Julia was at the hospital last Thursday for Heart Transplant clinic, Oncology clinic, and a GFR (kidney test). The good news is that Julia's heart biopsy was good. It showed mild rejection, which is expected. The team does feel that this biopsy was a little soon after chemo so although they were very happy with the results they will re biopsy her in 6 months. Her kidney test showed mild improvement from last year, and they will continue to monitor her kidneys. From a heart transplant perspective everything looks good. The chemo seems to have had no drastic effects on her heart. They were very happy with the weight she has gained. She is finally at an age appropriate weight. The nurse even joked and said "wow! It's amazing what a little chemo will do". We are scheduled to have clinic again in December along with an echo (test to check heart function).

We then went to see Dr. Punnett from Oncology. She is the most amazing, caring doctor I have ever met. We talked about the fact that Julia is still neutropenic (no immunity). She agrees that at some point we will have to take her off her injections (as she has been on it for 1 year), and see if she can hold her own, but she will not trial her off until at least 6 months post chemo. So it looks like we have to put her through these injections for another 4.5 months. One of her blood tests which were showing an abnormality in her T cells (very concerning), has returned to normal. I know most of you have no idea what I am talking about but this is fantastic news. Dr. Punnett believes these cells were reacting to the PTLD. She stressed how important November 6th's CT scan is. She told us that this is "the big day". This will give doctors an idea of how well the chemo worked? If she is in complete remission? or will we have to continue with more chemo? All we can do right now is wait patiently and hope and pray for a good scan. We will meet with Dr. Punnett after recovery for the results of the scan. If the scan is good we will make plans for taking out her PICC line, and go from weekly blood work and clinic to hopefully monthly blood work and clinic. The protocol for PTLD is a 1 year follow up with Oncology until we will be considered free and clear.

Julia is feeling good, and having an amazing time at school. She is so excited to be able to do everything Anthony gets to do. She has become better and better with the hospital visits and her home care nurse who comes in everyday. She even has started giving people lessons on her PICC line, how it works and what it's for. It's actually quite funny and also so sad at the same time. She has made so many friends at the hospital, and all the nurses make her feel so special.

Once again Elio and I thank you all for your thoughts and prayers, and ask that you all say a prayer for her scan on November 6th. We have been so stressed out and worried about this scan. It all comes down to this scan. The last 6 months of hell all comes down to this one day. It could finally be the end of a horrible journey or the beginning of complete hell. I will let you all know once we receive the results from the scan.

thanks
Nadia