Tuesday, April 29, 2014

Standard course of treatment

At this stage in Jaxon's treatment, all indications are that he will follow this protocol, understanding that there may be delays or complications that could arise over the 3 year period.

Visit the Children's Oncology Group online to learn more about ALL.


About treatment, from the Children's Oncology Group website: 

ALL is a cancer of the blood, so treatment is systemic, meaning it affects the entire body. At the time of diagnosis, the healthcare team will insert a central line to provide treatment.
Chemotherapy is the mainstay of treatment.
  • Induction:
  •  The first phase of treatment usually lasts four weeks. Children receive three or four drugs by mouth, intravenously (into a vein), or into the spinal fluid (intrathecal delivery). The combination of drugs depends upon the leukemia factors as above. The goal of this phase is to kill the leukemia cells and allow normal blood cells to return.
A bone marrow aspirate is performed at the end of this phase. The bone marrow is examined under a microscope, and is expected to show only normal cells. This is called remission. This does not mean that the child is cured, because without further treatment the disease will return. However, it is a very important first step on the road towards being cured. Nearly 98 of every 100 children with ALL enter remission at the end of the first month of treatment. Other tests (such as minimal residual disease) may be performed on the bone marrow and may be more sensitive at finding leukemia cells than looking under a microscope.
  • Consolidation:
  •  The second phase of treatment lasts from 12-16 weeks. Different drugs from those used during Induction are given by mouth and intravenously.
The purpose of the consolidation phase is to kill leukemia cells that may remain after the drugs used in induction. Another main focus is on treating and preventing the growth of leukemia cells within the central nervous system (CNS prophylaxis). To accomplish this, spinal taps with intrathecal chemotherapy (directly into the spinal fluid) are performed weekly. For certain types of leukemia, or if leukemia cells were present in the spinal fluid at the time of diagnosis, radiation therapy may be given to the brain and the spinal column during this phase. In most cases, part of the Consolidation phase will include treatment with the chemotherapy drug methotrexate. Methotrexate is given intravenously, either at lower doses in the clinic or at higher doses that require a 2-3 day stay in the hospital.
  • Delayed intensification:
  •  This 8-week phase of treatment includes medicines similar to those given in Induction and Consolidation. This has been shown to be helpful in preventing leukemia from returning. The exact timing of the doses and the specific drugs used depend upon the individual characteristics of a particular child’s disease.
  • Maintenance:
  •  The final phase of treatment lasts two or three years. Maintenance is much less intensive than the previous treatment and consists mostly of oral medications given at home. There are also intermittent intravenous and intrathecal medications given throughout this phase.

Good news on Day 19!

Today is Day 19 of Jaxon's first stage of treatment, called Induction. We were told at the beginning that by Day 29 he should be in remission. On Day 8, a special blood test was taken to check his MRD (Minimum Residual Disease) level, to see how he has responded to treatment so far. We got those results today, and are pleased to report that he is responding very favorably to treatment and Dr. expects complete remission at the end of 29 days. It still means a long (3 year) treatment plan, but it's good news because it shows that he is responding (and not resistant) to the chemo. He is still feeling crummy, as is typical during Induction. Eating and resting lots.

The goal at the end of Induction (May 10) is to see less than 0.01% of disease. The MRD test on Day 8 showed he was at 0.15 (it was 90% @ diagnosis). Our Dr. is confident that the trend will continue, to bring Jaxon to full remission.


This is the expected course of his recovery. We are still looking at a 3 year period of treatment, most intense now and for the next 7 months and lessening in intensity for the remaining 2.5 years.


We are working out the balance of keeping his nausea at bay and making sure his bowels move frequently. We were told to give him anti-nausea meds (Ondansetron) on an as needed basis. Over the past few days we've come to realize that he needs them constantly. We are currently chasing the nausea, and need to get on top of it to keep him most comfortable. 


We're tremendously grateful for the many oncology families we have met either in the hospital, here at Ronald McDonald House (RMH), and through connections with friends and family. Sharing experiences and comparing notes with them has been immeasurably comforting and helpful.

Friday, April 25, 2014

April 25

Our BCCH clinic appointment went well today. 

He received his third dose of Vincristine (VCR). Standard protocol for this phase of treatment (Induction) is four doses of VCR in the first 30 days. Final VCR scheduled for Friday, May 2. 


His counts look good, no need for transfusion. (Thanks to the many of you who are donating blood in honour of our boy!) We learned today that upon diagnosis, his bone marrow contained 90% blast (bad!) cells. Healthy marrow contains less than 5% blasts. No wonder he was feeling crummy! As of today his white blood cell count (WBC) is up, which means the cancer (still called a tumour, though it is not a mass) is reducing. Today's WBC is 1.2, target range is 5-15. 


We return for blood work on Tuesday, late morning.

Thursday, April 24, 2014

April 24

My little son woke up at 7:00 am and chirped the words that every mother loves to hear ... "Mom, I really really want some cake." He is on a heavy dose of a steroid called Dexamethasone (DEX) which is a major cancer fighter. It also causes intense cravings and makes kids obsess over food. I said no to cake for breakfast and 15 minutes later we agreed on some (low sodium) chips with sour cream. That will be his breakfast appetizer. A proper breakfast will be discussed later. He had a really good day yesterday and is in fine form this morning so far. We go for his next clinic visit at BCCH tomorrow morning for blood work, chemo #3 and check-up with our oncology team.

Tuesday, April 22, 2014

April 22

An opening became available for us to move into Ronald McDonald House (RMH) so we did just that yesterday! Jax settled in quite nicely and we are enjoying the kind and thorough staff and routines here, and have already met families that we plan to keep in contact with as we continue this journey. Jax was skeptical about a new place but warmed up quickly to the idea. We expect to stay here until the home closes on May 5 for several weeks while they move to their new location. After May 5 we will stay elsewhere until the completion of Jaxon's Induction phase of treatment on May 10. After May 10, our Dr. expects we will be able to return to the Island. Further treatment and appointments on the Island will be in Victoria, and we will have to return to Vancouver for a few days at a time for certain stages of treatment over the next 5 months. This is the current plan, knowing that there could be setbacks or changes at any time. Clinic appointment went well yesterday, his Hgb is holding at 105. Other numbers are low, as is to be expected.

Monday, April 21, 2014

April 21

It's been a lovely day. Jax was in good spirits and felt good too. Spent the day visiting with family and friends at Easter Seals, and now tucked in for bed at my cousin's home. We are well cared for and loved abundantly. Oncology clinic appointment sometime tomorrow for vitals, blood work and chat with our Dr. and his team. Scheduling was tricky over the long weekend so we are to call in the morning for appt. time.

PZ : Faith

Although Christians often use the argument that macro evolution doesn't exist because the greatest factor within it is "billions of years," we would do well to remember that on this day we claim to believe in something that happened a number of years ago as well; that we are trusting in the historical account and whatever empirical evidence supports the life, death and resurrection of Jesus.

On the other hand, if macro evolution is not true, the worst that could happen is a few professors lose their jobs and many people now have to come up with another way to understand how we got here and what the meaning of life is. But for Christians, if Jesus was not raised from the dead then we are ruined. Without hope. Lost.

Once a person responds in faith to Jesus and experiences new life, the alternatives are somewhat gloomy. Sure, someone on the outside looking in can easily say that Christians are brainwashed, supported by a crutch, or even just too "simple" to get the grander story. And to some degree, they'd be right. Christians don't know the whole story. We recognize our need for a Savior. And when faced with incredibly confusing and painful situations I have to say that the alternatives to a loving God who paid for our sins and offers new life don't really measure up.

As our journey has now brought us to deep dark places of emotional undoing, I can't imagine going through it without faith. And I know that I cannot "prove" that my faith is real or that God is real to those who wish to disregard it, but I can say that the alternatives simply do not bring any hope.

Being a Christian doesn't make sense. The irony in it is that one must lose their life in order to find it. Being a Christian means we don't have all the answers, don't understand all the complexities of life, and don't feel we have to. This isn't being naive, it's being real. Who in this world ever could know everything! By trusting in Jesus we release our need for control and in so doing we find that our lives begin to make more sense. While embracing mystery we discover that God tends to do things a little different than our wisdom might suggest; He asks us to trust Him and when we hand our lives over He gives us a peace that is unexplainable.

I believe that Jesus died on the cross and took upon Himself the sins of the world; that on the third day God raised Him from the dead; and after showing Himself to His followers He ascended to the right hand of God. Call me what you want, but I cannot imagine life without faith in Jesus Christ.

It's in you to give.


In the past 10 days, Jaxon has required about 4-5 blood transfusions. This essential part of his treatment sent his hemoglobin from rock bottom 40 to a pleasing 105 several days later. I'm not a blood donor yet, but I plan to be as soon as I have some spare time. I know of others who are donating because of Jaxon's story. If you are able, will you be one of them as well?

Sunday, April 20, 2014

MSP

I have never before been so grateful to pay our $25 MSP bill. 

It really paid off this month.

Saturday, April 19, 2014

O.O.H. (Out of Hospital!)

First night out of BCCH. Thankful for family who provides our own space while on the mainland. What a whirlwind week its been.

First night out of BCCH. Thankful for family who provides our own space while on the Mainland. What a whirlwind week its been.

We stayed with my cousin and her sweet family for the first three nights out of the hospital. It was such a gift to be in a home and with family, especially over Easter. Jax was still a bit out of sorts so didn't feel up to much activity, but it was so good to be there.

Paska!

I wonder where one can get fresh homemade Paska, delivered to wherever I am, somewhere in Vancouver?

... photo and story to be added ...

Discharged!

We have our walking papers!!! Packing up and heading to my cousin's, not far from here! Jax might shed his first tears since this all began when we have to turn off the movie he just started watching.

Breakfast instructions

Having breakfast with a spunky little boy today. "When I say E, I want eggs. When I say M, I want milk."

Friday, April 18, 2014

PZ : Easter & Brokenness

My body, broken for you. 

These words of Jesus have taken on a new meaning for me this Easter. Perhaps my heart is beginning to understand what Jesus' mother, Mary, was feeling on this day 2000 yrs ago.

You see, when our child's life no longer becomes something we as parents can fix, it breaks us. When those whom we are called to be responsible for are so far gone that our efforts are futile, it can take us to dark places, mentally, emotionally, spiritually, and even physically. When we, as parents, are no longer in control and are faced with the reality that whatever end is in store for our children is now out of our hands, it can ruin us.

A week ago our family was there. As parents we had nothing to offer but our hands and feet; our broken hearts for our innocent 5yr old son. Things were out of our control and as we laid him down on the operating table and watched his eyes close because of the anesthetic, it was our undoing. We knew at that moment that whatever happened next was out of our hands...it was up to God and the wisdom He'd given to the doctors that would determine Jaxon's outcome. We wept for our boy as any parent would. The sense of helplessness contrasted with the sense of responsibility, coupled with his childhood innocence...was too much to bear. So we gave him up...we let go...we laid him at his Father's feet.

But what about Mary? Her son, Jesus, didn't have a disease, he had a calling. He was not innocent like a child is, but was innocent in that He had no sin in Him. He would voluntarily give his life up, not because he was sick but because He was healthy. How did that make Mary feel? How would she deal with the pain and loss of her miracle child which God's Spirit told her was the Savior of the world?!!! Mary didn't have to lay Jesus down, He did it himself. And the mystery here is that He did it for her, for me, for you, and for the world. Jesus gave his life so that we may have life.

Our bodies are alive because they have blood running through them; the heart is a wonderfully complex yet simple organ. Without blood our bodies are lifeless masses of flesh and muscles and organs. When the heart is stopped our bodies die. This is the wonder of what Jesus did at Calvary...He gave His life up so that our hearts could be brought back to life! Jesus laid His life down so that our bodies would not just have blood flowing through them physically, but that our hearts (our souls) would become alive with God's Spirit. And where the Spirit of the Lord is, there is freedom!

Although we remember Christ's death today, we can also remember that in His death we are freed from death. Because He chose to do what we could not do ourselves (namely, make ourselves alive spiritually), we are now free to embrace Christ's life for us or reject it.

On this Easter I am more aware than ever before the pain which Mary must have endured on that day at Calvary. I am also more aware of how helpless we can be as parents when we don't have the answers or reasons why something seemingly bad is happening to our child. And yet I am also now more aware than ever before that putting our full trust in Christ is where real peace is found.

His body, broken for you ...

Thursday, April 17, 2014

April 17

Quiet day for us at BCCH. Jaxon's procedure* this morning went well. He's been feeling tired and woozy so has been resting a lot. He had three days of decreasing hgb so they transfused him and he went from 76 on Wed morning to 102 today! Tomorrow we will rest and visit with some special folks. IV chemo on Saturday. We expect to be discharged over the weekend and be back to see our oncologist in the clinic on Tuesday. He and I will be staying with my cousin here in Van for most of the remaining 3 weeks. Pray for his energy to bounce back tomorrow.

*Intrathecal Methotrexate

"Intrathecal" describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Medicine can be injected into the fluid or a sample of the fluid can be removed for testing. Chemotherapy given intrathecally can kill cancer cells throughout the brain and spinal cord. 

(Jaxon receives IT MTX 3 times in this initial induction phase of treatment as a preventative measure. His spinal fluid showed no signs of cancer at time of diagnosis.)

Wednesday, April 16, 2014

Another special friend!

More 'H' love for my boy. That family has a LOT of love to give. xo
Jax & Erin, Summer 2013

Newsmaker

Little Jaxon makes the front cover for the second time in months.  Wish it was under better circumstances, but amazing to see all the support pouring out for one of our Imadene families.  Love you @rjoyz & @paulzalinko #supportthezalinkos #curejaxon #helicopterride

Posted by our friend, Paul's boss.
Little Jaxon makes the front cover for the second time in months. Wish it was under better circumstances, but amazing to see all the support pouring out for one of our Imadene families. Love you @rjoyz & @paulzalinko

April 16

Jax and I had a good sleep. He was surprised to hear it was morning time already. He's starting to experience some jaw pain, a known side effect of the chemo (Vincristine - VCR) he received on Saturday. These folks are very generous with morphine so he's sleeping again, awaiting it to do its thing so he can enjoy his much anticipated bagel with cream cheese for breakfast. Our days are pretty quiet. Lots of playing laughing and eating. Oh my, the eating! Constantly hungry. iPad, iPod, iPhone, Leap Pad, movies, Lego, an inflatable rocket ship ... So far the benefits outweigh the discomforts for him! Tomorrow sometime he will have his second dose of chemo that gets injected into his spinal fluid. The fluid does not show any cancer, but cells can hide there undetected. The injection is necessary to kill any stowaways, as the IV chemo does not cross the blood brain barrier into the nervous system. He will be comfortably sedated for this procedure. Thank you for all the notes of encouragement. Keep 'em coming!

Tuesday, April 15, 2014

Perfect gift!

Somebody's getting out of this world treatment over here! 

*Insert alien eyes pic here!*


#‎wearegrateful‬‪#‎goodtolaugh‬

Thank you, T & A! xo

Special friend!

*insert Lisa's awesome picture here*

I can't wait to see this girl this week. Your love for my boy blesses this Mama's heart more than you know. xo



Monday, April 14, 2014

PSA

Just opened my webmail to 200 new messages. If you hope to hear back from me, please use FB or ask me on FB for my cell # to call/text if you don't already have it. We love hearing from our friends and family! Don't stop reaching out! Please remember, any visitors who come must have NO SIGN of illness like cough, sore throat, runny nose, sneezing. There are some very sick children here among us and a virus could be devastating. Jaxon is also at a high risk to contract an illness that his body is not able to fight, which would be a setback to his treatment.

Persnickety

My answer, when asked how Jax is responding to the chemo ... "Great! The steroids* are more problematic right now as they make him rather demanding and generally persnickety."

*Heavy dose of Dexamethasone (DEX) - a powerful cancer-fighter!

A familiar (and familial) road

April 14, 2014

From Paul's Mom, Frieda (Oma to our boys) ...


Today is my daughter, Debbie's, 40th birthday, 33 years after her treatment for leukemia. This is particularly significant today because it reminds us of God's faithfulness and it gives us confidence that Jaxon will have many more birthdays to come!

Sunday, April 13, 2014

PZ : The Hope we have

The past few days have been a whirlwind of emotions, information, tears and joy. 

From the moment our Doctor called us and told us to go to the hospital to meet with the pediatrician, we knew something big was up. 

When the pediatrician said we would be taking Jax to Children’s Hospital via the ferry, we knew something big was up. 

When the same pediatrician came back and said the Medi-vac Helicopter was going to take Jax to BCCH, we knew something big was up.

When BCCH told us the blood work showed Leukemia and needed to be confirmed by bone marrow biopsy, we knew something big was up.

When BCCH told us that it was confirmed that Jaxon had full blown Pre-B A.L.L, we knew our lives would be forever changed.

And I in no way want to downplay the roller coaster of emotions and pain that this had been, but through it all we have been told what was happening and what was going to happen to make it better. I hope you realize how freeing that was for us.

We knew what Jaxon’s problem was.

We knew we were in the best place we could be (BCCH) to treat this disease.

We know that his chances of having a full recovery over time is very high.

We know that God and His people have been overwhelmingly supporting us as His Church through and in all of this.

We ALSO know that many, many parents do not know. They don’t know what’s wrong with their kid. They don’t know who’s going to have the answers. They don’t know what treatment will look like. They don’t know what kind of impact this will have on their normal everyday lives. They don’t have family to support them. They don’t have friends to support them. They don’t have the family of Christ to support them. They don’t have Christ to be their cornerstone; their rock; their everything.

Today, please pray for those who do not have this hope.

Saturday, April 12, 2014

Diagnosis: A.L.L.

I thought I had posted this yesterday, but I think I only shared the link about our fundraiser. About that fundraiser ... we are completely blown away by this incredible response of support. Paul wrote this yesterday, and I've made a few changes to it, based on new information from our team today. We have been taking in SO MUCH info, that it's been hard to keep all the facts straight. Sorry for the delay, I thought I had already put this out there. :)

We had our "Family Meeting" at 1:00 on Friday April 11 to find out what this journey of fighting Jaxon's Leukemia will entail.

1. The type of cancer is Pre-B Acute Lymphoblastic Leukemia (A.L.L.)

2. Here's a general timeline...

- First month: He received his first dose of IV chemo (Vincristine) today, as well as several other supplemental oral medicines to counter various side effects of the chemo. He will take those supplemental oral medicines for 28 days. He will receive Vincristine once on each of the next 3 Saturdays. He will receive another important medication (starts with a P, that's all I know) on Tuesday (Day 4). On Days 8 & 29 he will have an injection to protect his spinal fluid from the cancer cells. He already received one dose of this on Thursday when he was sedated for his bone marrow biopsy. Jaxon will lose his hair, be irritable, hungry, (hungry + angry = HANGRY ... our Doc loved that new word), put on weight, and generally not be himself. We have been told that this is the "grin and bear it" time...it will get better! He will be here at BCCH for one more week, then it is expected that we will be discharged to local accommodation for another week so that he can come back regularly for blood count checks and the next dose of Vincristine. At that point it may be possible for us to return HOME where he could have some check-ups and chemo in Victoria or Nanaimo.

- Next seven months: "Regular" visits for IV chemo, daily oral chemo, regular checkups at a hospital, possible hair growth, improved ability to play and interact but somewhat limited.

- Last 2-1/2 years (So, 3yrs total!): This is called the "Maintenance" period. Jaxon will take daily oral chemo, have regular checkups, will be susceptible to a few reactions more than normal but will for the most part be a growing little boy.

So, at the end of the three year term Jaxon will have a clean bill of health and is expected to be fully cured of cancer!

3. Paul and I are overwhelmed at the hundreds (if not thousands!) of people supporting us through this already. Your many prayers have bolstered our faith and God's peace is with us.

4. Some of you have been asking about financial implications through this time. We really don't know what those will be and didn't anticipate that so many would want to help in this way, so our friends have made an online fundraiser on our behalf that you can contribute to if you want to support in that specific way. On the one hand I am torn about this because there are so many others that could use help in this department more than us. On the other hand, I know from personal experience what a blessing is to give (especially to a specific need) and do not want to get in the way of people being blessed through generosity. So, below is a link to our fundraising page if you feel so led to support us in that way.

Thank you all from the bottom of our hearts. This next month will be the toughest, so pray for courage and strength as we watch our little brave boy take this battle head-on!

5. I really need to start a blog.

Thumbs up!

LINK TO PHOTO HERE! (will update to add photo to post)

VAD surgery

Jaxon will be going for surgery at 8:00 this morning and will come out about an hour later with a central line and access port. Doctors call it a 'Vascular Access Device (VAD)', kids and parents call it a 'button'. It will be the main access to receive his meds and fluids, for blood draws, and means far fewer pokes in the hand and arm. He currently has an IV in his hand, so that will be removed. He'll be much more comfortable and have his hands free from lines and other stuff.

The surgeon had an unmistakably Norwegian name. That, and his kind and thoughtful care of us was an encouragement. 

Friday, April 11, 2014

Fundraiser

On Friday April 11th, our dear friends (the kind of friends who are more like family) started an online fundraiser on our behalf. We are honoured and humbled by their initiative, and by the overwhelming response from friends, family, friends of family, family of friends ... and complete strangers! This gift is a blessing beyond what we can describe.

Support the Zalinko Family on youcaring.com.

PZ : House Builders

Yesterday it was confirmed that our youngest son, Jaxon (5), has Luekemia. I've shared Rachel's posts as she is more articulate than I. Thank you for the overwhelming support!

Also, when it comes to calling things blessing or curses, I want to be careful. Sometimes the things we think are blessings turn out to bite us in the back. And other things that we think are a curse turn out to be something beautiful.

What we KNOW is that our lives have now changed forever. We are no longer the same. Something is different now. But God has not changed. He is always the same. And His love for us, for Jax, for our family, indeed for all the world is unchanging!

Yesterday I wondered if as a father I could love my son more; that maybe if God loved my son even half as much as I do then He would feel the pain I'm feeling. What I realized is that not only does God love Jaxon as I do, He loves him even more...more than I ever could! So much, in fact, that He sent his Son to die for me, for Jax, for all of us. Jesus conquered sin and death, and in His great love for us all He made a way to peace, to shalom, to rest.

And so we wait in that rest. We wait to see how God will use the life of our little Jax to show others His love for them. Already yesterday we could sense that the staff could tell our lives were rooted in something that many people in similar circumstances don't have.

Faith by nature is about mystery and trust. Faith doesn't have all the facts and if it did then it wouldn't be faith, it would be fact. Faith isn't a math sequence or science formula. You can't understand the mystery until you embrace it. To this degree, it is unreasonable; it doesn't make sense by looking at it. For those who do not have it, they wonder how in the midst of turmoil and suffering someone can be at peace!

Remember the two builders who built houses in the Bible...I think Luke 6ish. One built his house on a rock and the other on sand. I always thought that one builder was smart and built on a rock and the other was not so smart and built on the sand. But in Luke it says that the one builder "dug down deep" and built his house on the rock. They were neighbours!!! One built his house in sand and the other dug deep and built it on the rock. And when (not if) the storm hits the houses, the results are very different.
This parable is about what's on the inside. On the outside the two houses may have looked the same; no one could tell the difference; just a couple spec houses beside each other with the same trim package. The foundations, however, couldn't be more different! What happens when the storms of life hit us...that's when we find out if our faith is solid. For me, even though the pain is real, our faith has been deeply rooted and we are in a hospital with others whose houses are collapsing all around us. We are their neighbours today. During this time others may look at us and wonder why our house isn't crashing down like theirs. Faith. Faith. Faith.

So continue to pray for us as we embrace this new journey. But pray for those who might be our neighbours too; that we might share our hope in Christ and see others find peace.

Shalom.

April 11th - 7:45am

After a good sleep, Jax woke up to the news of an arm poke. Sweet nurse Michelle had already put magic cream on so it wouldn't be so ouchy. All he said was "Oh, brother." Not a flinch or a fuss and now he's back asleep.
Botanical Beach (Port Renfrew, BC)
January, 2014

Thursday, April 10, 2014

April 10th - Evening

24 hours ago we got a call from our family doctor that started the chain of events to where we are now ... Jaxon has leukemia. This has been a big scary day but also a blessed one as we have seen such a tremendous outpouring of support. Tomorrow is another big day as we will learn what type he has and what the treatment plan will entail. The oncology department at BCCH has been phenomenal! We've had some times of stunned reality and big heavy tears. Jaxon is doing well considering all the pokes and hubbub. We are expecting to stay here at least a week and will know more about what happens next after meeting with our team tomorrow. Boys are home with Oma and our camp family. We have several options for places to stay near the hospital. My parents will be coming tomorrow. Visitors are welcome, just text ahead of time and please do not come if you or your kids are ill.

April 10, 2014 - Morning

My Jaxon (5) and I will soon take our first helicopter ride. It will take us from Duncan hospital to Children's Hospital in Vancouver. Paul caught the first ferry of the day and will meet us there. Jax has had a mild cold/cough since March 28, though it has improved. Since April 1, we have had numerous people ask us if he is ok, as he was very pale. This prompted us to see our family Dr. again to see about blood work. That was done at noon yesterday, April 9. Results from initial blood work were troubling, frighteningly low hemoglobin. She referred us to the pediatrician on call who wanted to see him in emerg ASAP. More blood work and chest x-ray in Duncan late into the evening. He slept well last night. Other than feeling slightly unwell and resting now and then, he has been the picture of health. There are many things that could contribute to these symptoms. All possibilities are being explored. Our older boys are at home enjoying time with Paul's mom. Thank you for your prayers. Updates will follow. xo