April 29, 2007 Update

Dear Family and Friends of Charley:

I’m Madeline, Charley’s teacher from Shrewsbury. I would like to update you as to what has been happening at the hospital the last couple of days.

I saw Charley on Friday afternoon. He was still in the ICU because the doctors had been concerned about his lungs; but Charley has been slowly improving. He had been using the BI-PAP full time (the big face mask) but Friday he used the small nose tubes for 5 hours. Saturday he had the nose tubes on for 7 and a half hours, on Sunday for 10 hours, and the amount/force of oxygen was lowered.

Charley has been fed by IVs since he was in ICU. His parents have asked the doctors about the possibility of having an additional dietary supplement given to Charley. This would consist of herbs and other natural nutritional and food enhancements. These could be supplied by a tiny tube (feeding tube) that would go to intestine. The team has arranged the appointment with the director of the integrated clinic on this Monday. Nothing has been decided about this.

The doctors are also concerned about Charley’s spleen being enlarged. Oftentimes an enlarged spleen can mean the presence of leukemia, but some infections may also cause the spleen to be enlarged.

White Blood Cells: a healthy person can have between 4,000-10,000 white blood cells. A couple of weeks ago Charley’s WBC was 60 and on Friday it was 110. This morning‘s lab results show the WBC to be at 210, so very, very slowly it's coming up. Importantly, his absolute neutrophil count is 130, 62% of white blood cells, which are true infection fighters. If the ANC continues going up, then Charley's body will be able to fight off various infections. His platelets are still low, though.

When I saw him on Friday, he was really, really tired and he slept most of the time. Erin, his other teacher, and his grandmother were there with him, too.

As many of you know, there was a medical team - parent conference on Friday, too. Dr. Peter Choo, a personal friend and physician, and I also attended. The team and parents discussed many different things: Charley’s overall health, his lungs, his spleen, the fever (why is there a fever? Is there an infection?), and the possibility of using an NJ tube.

Right now his sepsis is controlled, his blood pressure is controlled…but he is weaker now than a few weeks ago, his heart is working hard, and he is labored in his breathing. He still has bouts of fever.

A wonderful decision was made about moving Charley back to 6 North into the big comfortable room. In this room he will be able to move around, sit on a couch, watch TV, play video games. He also will be able to be beside his mom and dad in the big bed, a closeness that he has been missing since he went to the ICU. The respiratory team will have their equipment moved to that floor in order to service him there if he needs the BI-PAP oxygen.
MOVING DAY IS MONDAY!

Prayer Requests :
* Please pray for strength. ….overall strength for Charley; and mental, physical, and spiritual strength for Deborah and Nehemiah. Pray that God will hold them so tenderly and close to His heart.
* Please pray that the decision concerning the use of the NJ feeding tubes will be the best decision for Charley.
* Please pray that the medical team will continue to be blessed with God’s direction and guidance regarding further treatment infections for Charley.
* Please pray for Charley’s lungs and spleen to go back to normal functioning and size.
* Please pray for his good blood counts to continue to grow to fight with.
* Please pray especially hard for Charley’s complete remission and cure of leukemia.

2007年，星期天，四月29号

田田亲爱的家人及朋友，

我是曼德琳，来自马萨诸塞州什鲁斯伯里，田田的老师，我这里向你报告一下最近几天有关田田的情况。

星期五下午，我去看了田田, 医生担心他的肺部感染，所以他还一直在ICU 病房，但他的肺部感染似乎在逐步改善。这些天，他一直在使用BI-PAP 面罩 (一种大的面罩)。星期五，他使用小型的鼻导管５小时，星期六，用鼻导管７个半小时, 星期天用10个小时, 同時使用的氧气量亦逐步降低。

自从田田到ＩＣＵ病房后，一直使用近胃管进食。他的父母问医生能否给田田中药或其他的天然保健品, 这些保健品也能通过胃管饲入肠道。治疗小组已安排替代医学主任下周一进行一次会诊。医生也考虑田田的脾肿大, 脾肿大常预示有白血病细胞, 但一些感染也可以引起脾肿大。

正常健康人白细胞在4,000-10,000。几周以前，田田的白细胞是60，星期五是110, 早上的報告显示白细胞是210, 很慢很慢地在上升。很重要的是，他的绝对中性粒细胞130, 占白细胞总数的62%, 这些细胞適用於與感染奮戰。 如果绝对中性粒细胞持续升高，田田的身体是能够对抗各种感染的, 尽管他的血小板还是很低。

当我在星期五见到他时，他真是很疲劳，大部分时间他都在睡觉, 他的另一位老师Erin以及田田的姥姥也在那里。

你们可能知道，星期五，又有一次父母与治疗小组的会议。Peter Choo 医生，还有我参加了这个会议。治疗小组与田田的父母讨论了许多问题，包括田田的总体健康状况，肺部感染情况, 脾肿大以及发热等情况 (为什么会有发热，是否是感染引起的??), 以及使用鼻空肠饲管的可能性。

现在他的感染得到一些控制, 血压控制也不错，但他比几周前更虚弱了,心脏负荷很重，呼吸困难，还常有发热。值得高兴是，医生决定田田可以回到北６區大而舒适的房间了。在这个房间里，他可以自由走动，坐在椅子上，可以看电视，玩游戏等等。他也能亲密地和他父母睡在一张大床上，自从去ＩＣＵ后田田就一直很懷念往日的親近和安全感，呼吸治疗小组将把呼吸救助设备安置在田田原來的房间, 以备用。預估回普通病房的时间是下周星期一。

祷告要求：

* 请求神赐予田田力量; 也从心灵、精神、身体上赐予田田父母以力量, 请神热情的拥抱他们，更接近他们的心。
*祷告使用鼻空肠导管是对田田最好的选择。

* 祷告治疗小组将在神的正确指引下进一步治疗田田的感染。

* 祷告田田的肺、脾恢复正常的大小和功能恢复正常。

* 祷告田田的血象能持续对抗感染。
* 特别祷告田田的白血病完全缓解和恢复。