Histopathology results

We recieved the best Christmas present we can hope for when the surgeon told us that the histopathology results were "negative for malignancy" on the removed tumour and the surrounding muscle margin. No atypical cells are seen. They are 100% dead.

We thank the Lord for this very positive result. God's word is very powerful, and we have repeatedly used his word to curse the tumor in Jesus' name. Just as Jesus cursed the fig tree and it withered from the roots, the tumor in Sam has withered from its roots.

Sam will now embark on the 3rd phase of the treatment. This phase requires Sam to undergo 8 more rounds of chemo treatment to eradicate remaining cancel cells that may not have been killed earlier. Each treatment will require 3 - 4 days stay in the hospital, with an interval of 3 weeks in between treatments.

We will start the treatment on the coming Monday, 19th Dec and we will be back to KKH.....

Back home, rehab, cold pads & afo

We are now back home for rehab.
Sam is resting well.
He has to undergo 3 exercises a day, all meant to get him back to walking again.
It's not easy, each exercise meant lots of pain and cold pads are needed to help ease the pain.
He still need painkillers too.
At the moment, he still can't stretch out his right leg completely, and is wheel chair bound.


Below is a picture of the scar left behind on his leg.
It is a long incision in order to remove the tumour.
About 15cm of the fibula, together with surrounding muscles and nerve are also removed.





Sam will need the assistance of an ankle foot orthotics (afo) in order to walk properly.
This device helps him to overcome the foot drop condition.

Today, Sam has his best friend over to our house, and they are happily playing computer games.
Nice to hear laughters in the house....

6 days after surgery

Thank GOD that we could be discharged today. Looking back, we are so grateful to
GOD for HIS unfailing love and faithfulness. We had started the surgery phase with
much apprehension, not knowing what to expect and to do, He saw us through with
strong support from friends and relatives...

- Friends who had helped us seek professional counsel;
- Friends who even booked appointments for us for 2nd opinions;
- Friend who accompanied us to the doctors so as to help us make more
informed decisions;
- Buddy and his mummy who came to our ward at 6.30 am in morning
to accompany us to the operating theatre;
- Godma who came to prepare Sam and prayed with him prior to surgery;
- Cancer survivors' parents shared their experiences with us
(some of whom I had not seen before!);
- CCF social worker who dropped by constantly to prepare Sam;
- Aunties and uncles who dropped by to cheer him;
- Neighbours and buddy that took care of Caleb during our hospital stay,
they even helped us to purchase his new school books and uniform;
- Friends that called constantly to cheer ;
- Aunty, Buddy's mummy, grand uncle and grand aunty who took time
to cooked and delivered home cooked meals for him when he refused
hospital meals;
- Buddy's mummy who run all the errands for us when we had to be in
hospital with Sam.

Indeed, we are so blessed! Thank you!


Latest Report

Sam was so determined to be discharged earlier that he walked quite a long way
with a walking frame to show the Surgeon.

The following is a report by Surgeon :

" Samuel had undergone elective wide Local excision of right proximal fibula
and peroneal nerve on 1st dec.

The operative findings were that of right proximal fibular Ewing's sarcoma
involving the neck and proximal metaphyseal fibular shaft with good response
to chemotherapy, with hardly any macroscopic soft tissue component. Previous
healed biopsy scar seen at the proximal peroneal compartment. The peroneal
nerve is seen to bury into the peroneal muscles at the proximal fibular neck
region. He tolerated the procedure well and is fitted with an ankle foot orthosis. "


Prayer requests

Surgeon informed us that Samuel is not out of the woods yet. Pray for speedy
recovery, healthy diet and positive histology report so that chemotherapy can
start soon.

Due to his physical condition, Samuel resists going out. However, he needs the
sunshine especially to overcome MSRA infection. The physiotherapy exercises
that Sam has to take is quite painful for him. Now, he cannot really straighten
his right leg. However, it is important that he exercises often to alleviate
his footdrop. Otherwise, may suffer 'long-short legs' phenomenon when he walks.

As he is in need of help most of the times, it can be very frustrating for him.
He is experiencing 'funny sensation' which added to his frustration(the doctors
explained that is due to his brain sending signals to the absent peroneal nerve)

He is also very concerned about catching up with his classmates in Primary 6.
We have tried to convince him to defer his studies but this is a non-negotiable
item with him now. We really do not know how to help him get back to his study
as his treatment tentatively ends in May-June next year.

Pray for encouragements for him to overcome all the difficulties he faces and
God will guide us as to how to help him.

Even as we trust in the Lord about His plans for Samuel, pray that HE will
direct our path and persevere.

3rd day after Surgery

Thank God that today Samuel can go off morphine and is no longer feeling nausea. He is recovering but needs a lot of encouragement to get him to eat especially hospital food.

We are very grateful to GOD for providing us with superb surgical team. The anaesthetist was so assuring, she prayed with us and made Samuel feel so at ease. She even played 'ANGRY BIRD' on the iPad with him before he passed out before the surgery!

It is important that Samuel eat well to recover and to build up before the next chemotherapy in 2-3 weeks time. Surgeon encouraged us that we have only 1 phase left to go. Another 8 rounds of chemotherapy and we should be on the road to recovery.

Please continue to pray against infection especially from superbugs, discomfort, restoration of appetite and speedy healing so that the next phase of rehabilitation can begin.

Tomorrow, the physiotherapist is going to fix 2 splints for him. Pray for thankful, cheerful and courageous hearts to adjust to the changes to lifestyle. Also, tender, loving care from the physiotherapist.

We are believing GOD for a miracle for Samuel. By HIS Grace, Samuel will be healed and be able to walk well soon to the Glory of God!

1st day after surgery

Thank God for providing us with such wonderful friends, doctors.


The operation went smoothly accordingly to plan - it was a wide ressection
about 15-16 cm of his fibula was removed along with part of his peroneal
nerve, muscles and other issues. He is resting back in the room and is
a bit feverish and feeling nausea.

Pray against infection, discomfort and restoration of appetite. Had not eaten
anything yet.

2 day before surgery

I am glad that we have made the shift to the new surgeon. Yesterday,he and his team made time to answer all my queries after consultationhours. He encourages us to do some outdoor activities with him before the surgery. At home, we also made time to talk to Samuel about the impending adjustments he has to live with. He has put up such courageous front. It pains my heart to know he may have to give up vigorous sports eghis favourite football. However, must trust GOD to open anotherdoor when he closes one. He is also anxious to get back to his schoolwork once he misses his friends and wants to join them soonin school. Prayer requests: Surgeon highlighted that once the tumour is removed, it will be sentto the pathologist for further tests. Pray for complete removal of tumour to be possible so that no othermeans of removal is required. Test results with 90% and above cancer cells dead, will indicate we will carry on 1st line of chemotherapy. On theother hand, we need to take 2nd line of treatment that is more vigorous. Please pray for favourable yet accurate prognosis as the 'MOP-OUT''treatment is vital. Pray for Samuel to be victorious in HIM to get UP and walk... and we will all stand by him strong to encourage him...

Prayers for protection and good preparation

From our pre-surgical tests, we discover that Samuel has some nasal

infection. SGH will prescribe some cream for this but advised that

Samuel goes outdoor for morning sunshine will help.

Pray that this infection will clear within the next 5 days before the

operation and Samuel will be obedient to go out.

Also, we are advised to be admitted 1 day before surgery on 30/11 to

better prepare Samuel for the surgery. We are expected to stay in hospital

for 2 weeks.

New hospital exercises very strict visitor register policy and at any one day,

only 4 visitors can visit. We were told that Samuel may be

put in the High dependency ward for monitoring

(no visitors except parents) before he is transferred back to the ward.

Prayer items :

Pray that God will be a reality and a stronghold in this time especially for

Samuel. We will make adequate preparation for this operation and recovery

plan.

Pray for God's mercy and grace to divinely heal Samuel.

Pray that God will grant the new surgeon wisdom to do the right resection

to remove only what needs to be ''sarcrificed". Pray against all the risks as

mentioned in blog. Good teamwork and health for him and his team.

Pray for strong support for Samuel - His peace and presence to be felt by him

and strength too as anaesthesiologist has mentally prepared us that there may

a need for pain management after operation. God will grant him courage and

speedy recovery.

Pray that Samuel will have healthy appetite and God will provide ways to

provide good meals for him. Till now, he still does not take hospital food.

Details on proceeding with Surgery on 1 Dec

Thank God for directing our path in the past few days!

After 3 days of seeking for 2nd opinions, we have decided to
change surgeon for Sam's surgery in another restructured hospital.

Somehow, this change is very clear. He was recommended by a cellgroup
mate(cancer survivor treated by new surgeon before) on Friday evening
who also helped us book an appointment with him on Monday morning.
Saturday Evening, another sister sms us about seeking him out after
consulting an expert. Today, our KKH oncologist confirmed the selection,
also citing him as her 1st choice from a list of 3.

This surgeon opined that we should take the 2nd option that is to do a
surgical removal of the tumour with a maximised safe margin. This removal
will include a big chunk of muscles, peroneal nerve and part of fibula in the 'tumour' zone based on 1st MRI. He explained that some 'chemo-resistant'
cancer cells may still be existing which will not appear visibly in the
MRI scans.

Unfortunately, till now there is no sure way to ascertain their presence, and
research has indicated a high chance of recurrence. The survival rate
for recurrence will be low as he hightlighted that very high dosage of chemo
will be needed for treatment which sometimes can be fatally dangerous eg
some patients died from internal organ failure. To explain things simply,
he used the analogy of saving a house on fire and not saving any specific furnishing 1st.

We have decided to proceed with option 2 engaging this surgeon as he could
explain most questions, and there is this calm disposition about him. After checking Sam's latest bloodcount report, with the view to improve the counts
to minimise the risk of infection, he scheduled the surgery to be on 1st Dec 8 am.


Prayer requests:

Please pray for smooth and successful operation (estimated 3 hr). Against
all possible complications:
- bleeding;
- infection;
- neurovascular deficit to other nearby blood vessels and nerves;
- neurological deficits due to nerve;
- deep vein thrombosis;
- incomplete resection

Please peace and comfort for all of us, to gear up both physically,mentally for
this major operation.


Today, I met the father of the 8 year old girl who I shared some time back.
She had a huge tumour on her cheek which did not response to chemotherapy
at all.

A very terrible prognosis was given initally - all part of her lower jaw bone will have to be removed. Perhaps, her right eye might have to go as it was
suspected that the tumour may have expanded up there too. Complex reconstruction from her own leg bone was needed to replace the cheek
bone.

Her father shared that he surrendered all to GOD pleading for HIS mercy to
save her life. They proceeded with the surgery expecting the worst but somehow
with full assurance that GOD will take care of everything. After the 12 hour surgery, the surgeon revealed he had only removed the tumour and some soft issues.

Father praised GOD and thank HIM for providing them with the one of the best tumour surgeon in town and apparently the only one who could decide on the spot as to what is most suitable. He was told now, the surgeon does reseach only.

PTl!

2nd opinions from 2 encologists and 1 surgeon in private practice

Past few days, we have consulted 1 adult encologist , 1 child encologist and 1 surgeon,  all in private practice.

Both adult and child encologists opined that since there is lung metasize, amputation is of not much significance. A relapse is still possible.  They are concerned about the aftermath of trauma of child  losing leg.

Child encologist and surgeon opined that surgical removal of tumour with maximised safe margin may not be possible for leg or arm. Studied both MRI and MRI report  to confirm that ‘’cherry” tumour does not engulf the peroneal nerve at all. It is near but they does not rule out the possibility of removal of tumour without damaging the nerve.

Child encologist proposed ‘’varying-margins” surgery and  highlighted that it is possible to perform the surgery with a pathologist on site to help ascertain the extend of removal by testing removed tissue on site. If the small margin removed near the nerve is not clear, a possible localised radiation   may be administered later to eradiate the cancer cells. Surgeon highlighted that we must be mentally prepared for a footdrop issue much as he tried to prevent it. For details, see http://www.youtube.com/watch?v=J7-L9MFRXD8&NR=1.

Child encologist is concerned about the nodes previously existing in Samuel’s lungs, he proposed to explore the possibility of localised radiation to curb the possibility of relapse here. However, he stressed that like chemotherapy, we have to balance the risk of side effects involved in radiation too.

Child encologist  is very concerned that surgery has not taken place within last week. 4^th week after chemo as chemo drugs normally wear off after 3^rd week.

 The last chemotherapy was 17/10 and yet the surgery was scheduled on 5 Dec. Usually chemo will resume 2 weeks after surgery. If surgery is confirmed on 5 dec, it would mean the next chemo will be late Dec or even January. Thus, there will be a lapse of 2-3 weeks without any suppression of cancer cells. Also, he opined that Sam’s blood count is most ideal for surgery now. He is concerned about the 2 nodes during this period.  

5 Dec is not ideal also for another 2 reasons – our KKH surgeon will be overseas from 6 Dec till ? and our KKH encologist is on leave from Dec 1 to Dec 14.

The private surgeon is a ex-kkH surgeon who may be able to work with the KKH encologist. He wants us to seriously consult with our encologist as before making this decision.

Now, we have to seriously consider the change of surgeon or perhaps even change of hospital. Many issues to consider eg are the opinions correct and is the surgeon suitable? Transfer of case notes, stem cells collected...Etc

Plans for next few days

Monday morning, we are seeking another opinion from a surgeon cum encologist from another restructured hospital. Hopefully, his inputs will assist us in this decision making.

Late Tuesday afternoon, we are seeing our KKH encologist after she meet with our KKH surgeon.

Wed reversal to KKH surgeon?

Wed morning(tentative pending our confirmation to engage private surgeon)

Discuss further surgical details with private surgeon and mental preparation of surgery to Samuel by surgeon.

Thu afternoon(tentative pending our confirmation to engage private surgeon)

Also, due to exigency of the need for chemo, we have tentatively requested him to book facilities for surgery on Thursday afternoon.

Prayer requests
Please pray for HIS peace to be with us, we will trust and will hear HIS voice to guide us in this critical period.  Specifically for HIS joy and peace to comfort Samuel as he is clearly shaken... did not eat or sleep that well. As a matter of fact, he had fever that night after seeing the surgeon.

His provision of the right, suitable and kind surgeon on time for this critical surgery.

Report from Surgeon

Today, we did not receive favourable results from the Surgeon. Nonetheless, we want to thank GOD for shrinking the tumour from the size of the apple to size of a cherry and keeping us.

Surgeon propose 2 options and leave it to us to decide:

(1) amputation from below the knee :
      [work based on worst MRI result but safest]

He explained that even though the tumour has shrunk, the area it previously
covered may have already been ''contaminated" and no one can rule out
the existence of possible cancer cells there. Unfortunately, there is no
sure way to determine their existence(apparently, ewing sacroma works
differently from leukemia cancer cells which may be determined via blood test
etc) thus they may not show up in MRI and CT scans.

Thus, amputation is the safest way to prevent a relapse from the leg.



(2) Surgical removal of tumour (with a maximised safe margin) and fibula.
      [work based on latest MRI result]

No reconstruction needed for fibula but some blood vessels, muscles
and the peroneal nerve is still affected. Potentially, surgeon can graft his
blood vessels but there is no way he can graft the nerve.

With the loss of the nerve, Sam will lose his sensation of the top calf and
top part of foot and be unable to move his foot up and down.
 Also, he may have to wear a splint to hold his foot up as he walks.

Although there is no impact on the growth of the bones in his right leg,
in the long run, he will have ''big and small" legs. Potentially, may risk a
relapse here too.



We are tentatively scheduled for surgery on 5 Dec afternoon. Surgeon will not be in
town after this. He has given us another appointment next wed expecting
a decision by then.


Sam is a bit shaken when the surgeon mentioned about recent death of a
acquaintence and a currently dying case on relapse. He prefer to go for 1st option. 


We intend to seek 2nd opinion. Please pray for GOD to guard our
hearts and grant us his favour to direct us to choose HIS best for Samuel.
We really need to discern HIS choice in this matter.


We appreciate and understand the love and concern for Samuel and our family,
and hence the desire to have the latest update in his condition.
However, this is the most critical period for our family and we may need the
space and time to decide on the best option for Samuel. Thus, appreciate that
you may obtain the latest information from this blog and refrain from calling
us. Thank you for your love and concern for us!

Latest update of wed test results ...

Thank GOD, Samuel's CT scan remains clear.
As before, the encologist did not comment on the status of tumour
based on MRI scan, just that it has shrunk further.

Much to our dismay, absolutely no comment on positioning of tumour or
the X-ray result. Therefore, we have to commit these results to GOD
and the surgery proposal to be revealed in next Wed meeting.

She explained that the chemo drugs may wear off its effect by 3rd week
after our 6th chemo on 17/10. Therefore, it is vital that surgery takes place
within this month. Further chemo after this stage is not advisable as the cancer
cells may get used to the chemo drugs and be able to suppress their effects.

Please pray for COMPLETE removal of the tumour without any
complication as encologist explained that any remnant not removable
via surgery may have to be eradicated via radiation.

Prayer requests awaiting Tests and Surgery...

Looking back, we thank GOD for His faithfulness... the fact that we have come this far is a miracle in itself.

This next surgical phase is a major test of our faith... Pray that as a family we will be able to overcome, by using our faith and the authority He has given us to deliver us out of this storm.

We have been reading up on all the possible surgical options pending the result. For those of you who are interested, you may want to find out more from http://sarcomahelp.org/learning_center/ewings_sarcoma.html

Pray for God’s continual protection upon our family in particular Samuel will be fit enough for this coming surgery which according to encologist should be performed within this month.

Pray for favourable result from Wednesday tests. That is CT scan remains clear, MRI scans and Xray will reveal that the tumour has shrunk significantly, dislodging completely from his critical arteries, nerves and veins to render a simple tumour removal surgery.

Pray for COMPLETE removal of the tumour with sufficient additional cuff of normal issue without compromising the functionalities of his leg. We were informed that the removed tumour will also be sent for further biopsy to ascertain how much cancer cells are dead.  Pray for high percentage of this.

Pray that GOD will grant the surgeon wisdom  to perform HIS best option for this reconstructive surgery. In particular, we want to commit the reconstruction of the fractured fibula to HIM. Also GOD will show us CLEARLY the path we should take for this reconstruction surgery. Pray for safe surgery and against infections. Trusting GOD for His healing upon Samuel.  By HIS grace, Samuel will be to get well soon and walk on his own.

Pray that GOD will provide for HIS best for this surgery... we are praying for availability of experienced surgical team and ward A in the orthopaedic  ward.

End of 1st Phase of Chemo - what's next?

The 6th Chemo marks the end of Phase 1 of the Chemo Treatment.

In 3 week's time (16th Nov) will be the appointment to meet with the Orthopedic Surgeon.
This appointment will reveal the followings:

a. the state of the tumour in the right leg (fibula)
b. where and how to remove the tumour via surgery
c. how much of the leg could be saved?(amputation was the initial proposal before chemo started)

As of today, the hardened lump has disappeared on the right leg after the chemos.
But we can still see with the naked eye that the right calf is slightly swollen and bigger than the left.

Xray, CT Scan and MRI will be scheduled in a fortnight's time.

Please pray that God will be gracious and save Samuel's leg.

Amen.

Day 2 & 3 of Treatment

Relatively smooth for the last 2 days.

Sam will start the day with breakfast, have soup for lunch and will avoid food for dinner.
That's because at 8pm is the start of the 2 hrs monster drip called Ifosomide, which causes nausea and vomitting. So Sam decides the best way is to avoid food completely, and sleep by 9pm. Actually, its a pretty good strategy by the boy.

Meanwhile, it will be flushing drips throughout the night till 11am tomorrow, where the final drip of Doxo (4hrs) will begin. After that, it's home sweet home. We surely are looking forward to that.

Cheers.

Day 1 of treatment

We didn't manage to get the A ward that Claire wanted very much. Instead, we are in a 4 bedder B1 ward. There are just 2 occupiers at the moment, Sam and another boy around his age. So it's not so bad after all. Just hoping that the beds don't get filled up in the next few days, so that we can use the space around us. Day 1 treatment started only at 3pm. We have now finished with the Vincristine, Epotopside and Ifosamide. It's flushing time, from now to tomorrow 11am before the administration of the last drug, Doxorubin. That will the completion of the first cycle, which takes a 24 hours. 3 cycles of this same treatment will complete this round of treatment. Samuel is now taking the treatment with stride. He read his story books, watch some TV, played with his PSP, got to computer games and Facebook. He ate a little bit of noodles for dinner, and is taking sufficient liquid. By 9:30pm, he is tired and went to bed after saying a short prayer. Mummy will spend the night with Sam at the hospital.

Preparing for 6th chemo next Mon 17 Oct

Thank you once again for praying for Samuel during his 5th chemo.
I know of a group of friends who prayed fervently for him for 3 hrs!
Thank you for your deep love for Samuel. We had a breakthrough when
Samuel took some meals that time.

Frankly, I was quite disturbed during our stay in B1 ward.
Some concerned friends and family members who visited
the patient opposite us seemed to have a tug of war between religion.
Very disturbing as some of them were 'forcing' the eight year old
 to choose between Jesus and Buddha in order to ursher in the ONE to
help her ! First night, there were prayers up to 11 pm ...
Miraculously through it all, Samuel still experienced a deep sense of
HIS PEACE and he slept through the commotion!

For 6th chemo, please pray for HIS provision for a A Ward.
I had been cooking simple meals for him in the hospital using
the hotpot as he rejects hospital meals. Pray that HE will help
me in Samuel's meal preparation.

Please pray for God's protection upon Samuel as he needed a
blood transfusion last week due to low Hb. Pray that
chemotheraphy will effectively eradicate the cancer cells and
for His protection to spare his good cells and whole being.

Often times, Samuel withdraws into his own room
to do his own things. Pray that we will be able to meet his needs
physically, emotionally and spiritually.

Sam has sore throat in the first weekend back home.
The GCSF jab on friday made him lethargic the following day.
We kept a watchful eye over him.
Thankfully, he recovered and this week, he is back to his usual self

Sunday was particularly nice as we have Ezra (Sam's best friend) at our house.
It brought joy to Sam as they chatted almost endlessly.
The next hospital consultation was planned for Sam & Ezra to be together, so the boys are really looking forward to it.

The massive lump on his right calf surrounding the tumour seemed to have disappeared to the naked eye after 5 rounds of chemo treatment
We don't know the condition of the bone tumour at this moment though.
Has it shrunk, is it still the same as before....?

We will need to wait for the completion of the 6th chemo treatment.
Only then will the orthopedic surgeon examine Sam and decide on the next action
Its pretty frustrating as the doc simply refused to tell us anything. Not even a word of encouragement.
In fact, we got ticked off for arranging a session to meet with the surgeon ahead of schedule.....

Well, MOH certainly trained their doctors well, all with good brains but i wonder why are their hearts and that little element of EQ?

Anyway, we still trust that God will save the leg and the need to amputate will not be necessary.
Please pray along....thanks.

5th Chemo Treatment - 26th Sep

Sam started the 5th Chemo on monday afternoon.
He has been taking the treatment very well.
He ate lightly for his meals, and also drinks regularly.
Thanks for all your prayers.

We have just started the Day 2 treatment as I write.
Pray that the next 2 days will be equally smooth and so that he can be discharged on thursday.

Home after 3-day stem cell harvesting stay...

Thank God,  the stay in the B2 ward for stem cell harvesting turned
out well.  Somehow, we can find courage and companionship
in the midst of the noise and babies cries. We encountered the 'real warriors'
there eg a pakistan couple who sold their land to be here to seek
treatment even though they were told the chances are very slim 10-20%.

Managed to meet the surgeon. However, was distraught to hear from him
that he will see us only after all 6 chemo are over. He added that we need to
maximise on the remaining chemo to save as much as possible.

Please support us in praying that :

- God will be merciful that the remaining 2 chemo will be effective in
   shrinking the tumour especially away from the 2 nerves.

- Samuel still rejects hospital food and he is preparing not to eat again.
   Pray against this deception.
  
- Next Mon, we will be admitting for the 5th chemo and potentially we need to
  stay in a non-enco A class ward.  
- God binds us to Him and our family together even more to walk in faith and truth ...

postponement of stem cell harvesting ...

Today Samuel's blood count was too low for stem cell harvesting.
As a matter of fact, all his blood types have dipped.
HB was so low that encologist made him go through a
blood transfusion today.

Now back home ... tentatively
to admit on Wed pending more positive blood count then.

Thank God, encologist confirmed that his lungs are cleared based on CT report.

However, we can only know the outcome of the latest MRI report
pending our appointment with the surgeon (a visiting consultant who comes in
on Wed only) on 5th Oct earliest. In between this appointment, there will be
stem cell harvesting and 5th chemo.

Please support us in praying that :

- there will be no further delay in treatment, Samuel's blood count can recover
  on time and no more complications

- if God is willing and in HIS timing,  that we will be able to meet the Surgeon earlier
  (possibly this Wed) to review results and even discuss surgery to remove the
  primary tumour from his right calf if the condition is favourable already

- Samuel to be obedient enough to sleep earlier and not reject hospital food
   today, he insists on the home cooked food only

- God binds us to Him and our family together even more to walk in faith and truth ...

 

2 days before stem cell harvesting

Next week, Samuel needs to go for peripheral stem cell harvesting
I reviewed the information in the following link with him today :

http://www.gosh.nhs.uk/gosh_families/information_sheets/peripheral_stem_cell_harvest/peripheral_stem_cell_harvest_families.html


He has requested everyone to pray for 
- earlier discharge as we need to be admitted again the following week for 5th chemo.
- smooth insertion/removal of vascatheter . Specifically against any vomitting from the anaesthetic used. He asked for “painless” insertion and removal as the removal of the stitches from his right calf was quite painful for him.
- courage for both mum and son to overcome fear of sight of blood flowing in and out from peripheral machine.

As with regard to his food probia and computer addiction, a very kind sister has encouraged me with the following :

“Pertaining to his attitude regarding food, besides praying against deception, I know of a practical way to help him. But it may not be feasible because he refuses to be in the children cancer b2 ward . When he sees other kids also eating hosp food, maybe he will not have so much phobia since he will not be the only one eating it. There are kids who stay there for 4 mths in a stretch, and they have to put up with hosp food too. When he sees that, maybe he will feel that his short stay is bearable as compared to other kids.

Pray that God will take away that phobia and He will sustain his appetite during his up-coming stay.

The same with the comp addiction, being in isolation cuts him from other patients whom he can otherwise play/chat with. I find this to be a great advantage for their social/emotional wellness when they have other patients to relate and play with.

Let's pray that God will remove that addiction and generate more varied interest apart from that.”

On Friday, we have received his latest MRI and CT reports, unfortunately the encologist is not available to explain the results to us.

Extracts from CT report :
Impression : No significant abnormality detected The previously noted tiny right lower lobe pulmonary nodule is no longer seen on the current scan. Hopefully, God has answered our prayers to totally remove the nodes from his lungs

Extracts from MRI report :
Impression: Known Ewing’s sarcoma right proximal fibula Stable intraosseous component with interval reduction in the extraosseous soft tissue component as well as the enhancement in the surrounding muscles.

Apparently, only the surgeon(a visiting consultant) can give us a detailed explanation on his MRI scans. We have not met him ever since our 1st consultation prior to 1st chemo.

Pray that next week during the stay, it can be arranged for us to hear from him
(with 2 MRI reports now).
Pray that primary tumour from his right calf can be removed as early as possible without compromising the functionality of his right leg. God will also heal the big fracture in his bone.

Day 3 at Home

Today, Samuel's white blood count has dropped to acceptable level. Friday, FBC again. However, was told by the encologist that whether surgery takes place earlier or not, we still need to complete tentatively the14 courses of chemo treatments. 4 down another 10 more to go. Was feeling burnt-out especially the next 2 weeks there will be 2 more rounds of hospitalisation again : - stem cell harvesting; - MRI, CT scans and 5th chemo. However, as I mediated upon the psalms 23 : The Lord is my shepherd, I shall not be in want ... Surely goodness and mercy will follow me all the days of my life. He comforted us with evidence of His presence in this journey : - I have the chance to appeal face-to-face with assistant director who happened to be at the centre about the ward A situation; - very last minute('miraculous') availability of MRI and CT scans ( was told earliest is last monday of this month, if not will be next month ) - availability of transport back home by a friend(who happened to be at hospital) - sister in law who had offered to cook lunch earlier in morning (not knowing we will be late) - a neighbour who happened to know the surgeon just dropped by to encourage us. Thank God for all these blessings and thank you for partnering us in this journey ...

Day 2 at home

This morning, the FBC (Full Blood Count)indicates that white blood count was too high(beyond normal high). Thus, need to monitor very closely ... instructed to go for another FBC and consultation with doctor tomorrow morning. Pray for smooth progression of this stem cell harvesting journey Pray for Samuel - to have healthier appetite - to increase his fluid intake - against vomitting as thus far he has vomitted 2 times. We have decided he will be admitted to a B2 enco ward (as all equipment and experts are there) next week which pose a great challenge for us. Pray for Samuel to overcome his probia as hospitalisation equate to starvation for him. Pray for good and encouraging companions in the shared ward. Pray for God to help our family to allow HIM to be in every part of our journey. He will put in place and restore all things right before HIM.

Back Home after 5 days

Discharged finally on Sunday, 6pm. It's actually against the doctor's instruction, as she is concerned that Sam is not properly hydrated. We told the doc that Sam will be OK once he gets back home. Truely, and thankfully, Sam is recovering fast. He started eating and drinking as usual, and the vomit spell disappeared. Thank GOD. This week will be a busy week. GCSF injection every day to be adminstrated. We have a neighbour who is a nurse in CGH, so she is helping out. Alternate day, we have to be back to KKH by 9am for blood count measurement. This entire process is to prepare for re-admission next monday for the Stem Cell Harvesting. PRAISE GOD that Sam is healing.....it's still a journey. With the 4th Chemo done (out of 14), we have completed slightly more than 25% of the journey... Long way to go though......

Day 3 & 4

It has not been easy on Sam for the past 2 days. He has frequent vomits and is weak from the lack of food and water intake. The good news is that we are approaching the end of the treatment. The last dosage of the drug should be administered this morning. We should be discharged by 4pm today (Sunday), according to plan. Certainly looking forward to going back home. This week of treatment has been tough going.

Day 1 and 2

Yesterday was pretty unpleasant for Sam. He threw up many times from the effect of the sedation drug administered for the BMA process. The boy refused to eat and drink throughout the entire day/night. Thankfully, he woke up feeling better this morning. He is now on light diet, chewing a couple of energy bars (chocolate coated to wet his appetite). The 4th chemo treatment started at 2pm today. Sam is now cheerful, reading his Jackson Percy and Artemis Fowl..... The next 72 hours will be a journey. Please pray that God will provide Sam with the strength, endurance and no more vomiting throughout.

Prayers as we prepare for 4th Chemo and Stem Cell Harvesting

This month, Samuel needs to go for peripheral blood stem cell harvesting
after the 4th chemo.


Stem cells are important cells because they can divide and change into many different types of cells that your body needs. Blood stem cells can be used
to treat certain types of cancer and other diseases. Peripheral blood stem
cell harvesting is a procedure that removes stem cells from your blood which
are then frozen and stored for possible use at a later stage. A person may
need blood stem cells to replace cells destroyed by treatments for cancer.


For further information, you may refer to

http://www.gosh.nhs.uk/gosh_families/information_sheets/peripheral_stem_cell_harvest/peripheral_stem_cell_harvest_families.html


Here is a list of activities that will take place :

06/9/11 Urine test

07/9/11 Admission for 4th chemo which starts with Pre-harvest
investigations and tentatively ends on 10/9/11

11/9/11 Daily G-CSF injections starts (to help his body make white blood cells)
Blood tests on TUE, THU, SAT to monitor his blood counts

19/9/11 Admission to hospital once it is confirmed that his
stem cells have been mobilised

Operation for Insertion of Vascatheter

20/9/11 Harvesting stem cells starts and hopefully can end on 22/9/11


Please pray specifically for these activities listed chronologically:

06/09/11 Urine test

Pray that Samuel will be disciplined to collect his urine for the whole day.
Once missed , we have to redo from start !
We may have to wait for a more suitable date for this collection to facilitate
this test.

07/09/11 Admission for 4th chemo

Pray for 4th chemo to totally remove the nodes from his lungs and shrink the tumour from his right calf such that earlier surgery is possible to remove the primary tumour.

Pray that there is NO need for a 5th and 6th chemo as planned in the treatment protocol.

Pray for functionalities of his right leg will not be compromised at all.

Pray that God will heal the fracture in his bone miraculously.
Have been warned by doctors against strenuous exercise lest this fracture is aggravated further.

Pray for protection of his vital organs and against all side effects
specifically vomitting. During 3rd chemo he had developed a slight diarrhoea too.

Pray that God will grant us one of the A class rooms in cancer ward (only 2 left)
to mimimise delays in treatments and near the experts for the pre-harvest investigations .

Pray that Samuel will overcome his probia of eating due to side effects of vomitting. As long as this issue persists, we may be forced to take class
A all the time because he will not allow food in the room.

Pray for hospital to consider providing a whole ward of class A rooms
for children with cancers/other ailments(that need isolation) in due of
the acute shortage of class A due to the on-going renovation.

[Having submitted my appeal to hospital, I am also exercising my faith in
GOD as I think this is not a selfish but feasible request that will benefit both patients and the cancer team that has to run over the place now]

[afternote for 3rd chemo.
Give thanks to GOD for HIS guidance(loud and clear) through a christian doctor
when we had to make the difficult choice between non-cancer ward (class A) and cancer ward (class B). Thank God that HE saw us through everything and there was only a minor hiccup towards the end. ]


Pre-harvest investigations

Pray that the various tests and investigations that he has to undergo can be expedited as he has to fast totally from 6 am. Pray for God’s comfort to be with him.


11/09/11 Daily G-CSF Injections

Thank God that a kind neighbour who is a nurse is willing to come to our place
to do this jab for Samuel. This saves us the daily trip to hospital.

Pray that God will keep her (and her backups) in perfect health and we will store and keep the medicine well.

Pray against all possible side effects - coughing, fever, easily become out of breath, swelling of the mouth, fever, diarrhoea, rash, abdominal pain, vomiting, hair loss and infection. This is first time that Samuel takes the daily G-CSF injections.

Blood tests

Pray that Samuel’s white blood cells to increase well according to plan and the day of the rapid increase can happen according to the date predicted.

19/9/11 Admission to Hospital once it is confirmed that stem cells have been mobilised

Pray that God will grant us wisdom to determine where to admit Samuel. Apparently, all the experts and devices are all housed in a ward which only has class B2
room (5 bedded). This is going to pose a big challenge for us.


Pray that God’s comfort for Samuel as he has to fast totally from 6 am for blood test and the operation to insert the vascatheter near his groin area.

Pray for smooth operation.


20/09/11 Harvesting stem cells.
Pray that god will send kind and experienced staff to take care of Samuel
during the harvesting of stem cells.

Pray for God’s comfort to be with Samuel as he has to remain in bed
during this harvesting of stem cells. Pray that he will be able to do
most of the things that he normally does - specifically reading and eating.

Pray against possible side effects of a drug given to stop the blood clotting.

Reports on CT Chest and MRI

Below are extracts on the above 2 reports received yesterday:

CT Chest:

Near resolution of two previously documented nodules in the right lower lobe. No new pulmonary nodules detected.

MRI:

There is a significant reduction of extraosseous soft tissue component around the right fibula. Small enhancing component ...could represent residual tumour.

We praise God for the near elimination of the cancel cells originally detected on Sam's right lung and also for the reduction in size of the lump on his right calf.
We thank you for all your prayers and support too.

While the lump in his right calf has almost disappeared, the tumour in the bone (right fibula) still exits. The process will now focus on saving the leg. Sam will proceed for his 4th Chemo treatment in 2 week's time. Afterwhich we will consult with the orthopedic surgeon for the next course of action on the leg (ie surgery process).

We appreciate your prayers for continued healing. Pray for:

a. tumour in the calf will continue to shrink so that it will not affect the nerves and major veins
b. amputation of the leg will no longer be needed
c. Sam's mental, physical and spiritual health to be strong.

Thank you.

Back to the hospital for Round 3 Chemo

We are back to the hospital for Round 3 of chemo treatment this morning.
The oncology ward is undergoing renovation, thus we are moved to a common ward for this stay.

The result for the CT scan is very encouraging.
The 2 spots originally found on the lungs have diminished in size.
From a 3mm and 4mm initial size, they are now visible only as spots.
No other spots are found.
The doctor concluded that the earlier 2 rounds of chemo is doing it's job.
We praise the Lord for His healing power.

The result on the MRI is available at the moment.

Meanwhile, we pray that Sam will make it thru the coming 72 hours of treatment without the nausea
and vomiting spells. We pray that this time of confinement to the bed will draw him closer to the Lord.

Prayers as we prepare for 3rd Chemo...

Thank GOD for all of you have been praying for us and supporting us in
many ways(eg marketing, run to libraries for Samuel's favourite titles,
buying his favourite stuff, sending Sam and I home after discharge).
May GOD bless all of you richly in return!


Pray for God's presence to go with us as we adapt to some changes this time.
- uncertainty of A ward, Derrick need to travel tomorrow nite.
Pray that we will have the frame-of-mind to rest in the faithfulness of
GOD to take care of every situation.


Pray specifically for effectiveness of the chemo drugs to destroy the
cancer cells, shrink the tumour(for possible early surgery to remove tumour)
and protection of Samuel's health. Two days ago, Samuel's nails have
darkened significantly. Earnest prayers of protection over his health
is coveted.


Pray that God will help us to cope when the chemo that causes greatest
discomfort is administrated(usually between 8 to 10 pm). Thank God for
answering our prayers during the 2nd chemo, HE helped Samuel to sleep
through this period.


Unfortunately, due to fear of vomit and unpleasant nasal feeling,
Samuel usually avoids food(consumes only 1 cup of milk, cornflake,
2-3 pieces of fruits, with other fluids per day). Pray for GOD's
grace to overcome this, and his input can be improved.


Pray for Caleb(with the LIMs again) and our homefront.


Tentatively, we will be in hospital from Tuesday to Friday.
A earnest request - as Samuel and I(Claire) may to wake up a few
times in the night, we need to catch up with our sleep
in the afternoon 2-4 pm.

Please refrain from calling us this time,
morning(our Peak time as doctors go through their rounds)
and nite (8-10 pm).

He Is Able Video from Samuel's classmates

Below is a video clip of Sam's classmates from St Hilda's Primary School performing and dedicating the song "He Is Able" to him.

Sam wants to say thank you to all his classmates and form teacher Ms Goh for their love and prayer support.

(sorry, video dont seemed to work!!)

Prayers as we prepare for CT scan and MRI scan...

God has been so good to us today! We are supposed to go to KKH
on 2 separate mornings for CT Scan and MRI scan initially.
A simple prayer answered on the spot - I go by faith to ask the
2 separate department nurses about combining CT scan and MRI scan
today - God answered ! Though we have to go back home first but
we can proceed to do everything today late afternoon. This saves
Sam the agony of doubling fasting and injecting the plug on his hand
twice.

This is a firm reminder to me that HE is in control and I need to
trust HIM even more.

My prayers for this day,

Dear Father-in-heaven,
Being just a 'human' mother, I agonise over the results of the
scans, nonetheless Lord help me to cast all these struggles to
you, grant me even the faith to believe and trust you for the
outcome. Remind me that no matter what happens, your love for
us never change - in romans 8. Yes, help me to choose to love,
worship you and trust you.

May our family be able to do as the palmist said in psa 62:5-6

Find rest, O our soul in God alone,
Our hope come from Him,
He alone is our rock and our salvation.
You are our fortress. We will not be shaken.

Amen.

Derrick is flying off late Tuesday next week. Doctors told us that
we cannot rush the imaging department for results. Please pray that
with the change this morning, he and I may get to know the results
firsthand on Tuesday.

AFTERNOTE : Imaging Department informed us that they need at least
1 week to process the results. thus we have to wait...

A sincere request, prayer partners may we request that you do not
'flood' us with phone calls too. We will post the results asap as it
is available.

Blood Count back to normal

The blood count check yesterday revealed very positive results, with all indicators back to the normal level. Praise the Lord.

This morning, we will be back to the hospital for the CT scan on his lungs. The previous scan showed 2 minor spots on his lungs. We are praying that this scan will reveal that the spots are gone, after 2 aggressive rounds of chemo treatment.

Tomorrow Sam will have his MRI on the tumor spot on his right leg. Pray that the result will show that the tumor has shrunk so that the surgeon can remove the tumor easily without permanent damage to the leg. If the tumor is still large, it will be difficult to save the leg and we pray against that.

Travel Plans for Derrick

Derrick will be travelling on Tuesday evening (16th Aug) for Melbourne.

I have already settled helpers for me for the 1st week.

Pray for journey mercy for Derrick. Claire and helpers to work
through smoothly the 3rd chemo phase.

prayer request for class A for 3rd chemo

Thank God for sister Wee Yee and sister Letitia (Samuel's godmother)
to take turns on/off to accompany me during 3rd chemo next week.
Letitia will also send us home upon discharge.

16 Aug - 19 Aug Third chemo
16 Aug - 23 Aug Derrick will be in Australia (tentatively 8 days);
he flies off late evening on 16 Aug.

-------------------------------------------------------------------------------------
Prayer request
----------------

Due to upgrading renovation, cancer ward 75 (children's block) has shifted to
ward 61 (women block). Time frame tentatively 4-6 months.
Resulted in only 2 A class rooms in ward 61.

Although we may have booked A class for 3rd chemo,
other more life-threatening cases will be given priority.

If unavailable, will be given 2 choices :

(a) Class A in other NON-cancer wards

- Nurses are not enco-trained nurses,
so may not be as experienced as ward 61 nurses.

Encologist encourage us to downgrade to B class
if necessary and shift back to A class upon availability.

OR

(b) Stay put in B class(4 beds in 1 room) of ward 61

- only 1 parent can stay overnite;
- sam's needs may not be met
(he banned food in ward previously as it makes him very nasal,
need the quietness to sleep through 'vomit' periods when specific
chemo drug is administered usually 8-10 pm);
- shared facilities => more germs? lack of privacy ?

We really need God's blessing to secure A class in ward 61,
and guidance to choose what is best for Samuel.

Covet your prayer support in this matter specifically peace of mind
for me(Claire) to rest in the faithfulness of GOD to see us through

3rd chemo with the above changes.

Specific prayers for Samuel now ...

Pray for protection for Samuel as he is experiencing loosening of his
molars - that GOD will strengthen his gums n save his molars.
Bless his bone marrow so that lots of platelets will be produced to
prevent bleeding.


Pray for good report for CT scan and MRI. Bless encologist with wisdom
to prescribe the best treatment for Samuel. Help his body adjust to all the
chemo drugs so that there will be no adverse reaction.


Each nite, as Samuel lay down to rest, grant him deep restful sleep so
that he awake each morning thoroughly refreshed and in good cheer.
He had been talking in his sleep for past few nites.


Bless him with intimate time with the LORD such that the Lord
will speak to him and he can hear... he will find time for not just
computers, TV, and PsP but GOD and more wholesome activities.


Bless Claire to plan and prepare meals that are essential for Samuel
No overcooking and will awake his appetite.

We are back home recuperating

Sam was discharged on last Friday evening, went back to the hospital on Sat afternoon for the GCSF (Granulocyte colony stimulating factor - needed to stimulate the bone marrow to make more white blood cells) injection. We are now back home recuperating and nursing the body to prepare for the 3rd round of chemo treatment, scheduled for 16th Aug 2011.

Every Thursday, Sam will be needed to visit the oncologist and also have his blood check to determine the condition of his blood count, particularly on the WBC which determines his level of immunity.

2 key dates to look out for prior to the 3rd treatment. (1) 12th Aug, go back to hospital for CT scan. There were 2 small nodules found on his lungs during the initial diagnosis, so this scan is to check if the nodules are still there after 2 rounds of treatment. (2) 13th Aug, go back for MRI on the leg to check on the condition of the tumor. Physically, the tumor seemed to have shrunk, as the swell and hardness are gone. The MRI will confirm the condition and also help the surgeon to determine the next course of action. results of the CT scan and MRI will be made known to us on the 16th Aug.

Prayers needed:

1) Sam's appetite for food and drink to return, that his health will be nursed back to strength.
2) his WBC level will improve, especially after the GCSF injection, thus improving his immunity against external virus and bacteria.
3) positive results from both the CT scan and the MRI
4) Sam's spiritual walk with the Lord to be strengthened.
5) unity at home, and amongst the caregivers

Day 3 of 2nd chemo treatment

We have Just finished the treatment for the day (10pm). Now is the flushing session (for the next 14 hours) where sodium chloride solution will be dripped into the body to flush out the waste. Sam took the treatment extremely well today. No vomiting. But he also ate very little ( small pack of cornflake, a banana and a pear). The mere mention of food will make him want to puke. He feels weak, obviously, after more than 2 days of avoiding solid food.

The school's vice principals and his form teacher from St Hilda visited him in the late afternoon (only at the door). They brought along many get well cards and notes written by Sam's classmates. Sam was smiling broadly when he read the cards. Really treasure the big smile on his face.

He is sleeping now, and so is Claire. It has been a tiring and emotionally draining 3 days at the hospital. Tomorrow we will continue with the last phase of the chemo treatment. The last drug will be applied around 12pm. There is a good possibility that we can go home tomorrow evening, after the full 72 hours of treatment . We are all looking forward to go home tomorrow. Praise the Lord.

Day 2 of Chemotherapy treatment

The most feared chemotherapy drug, ifosfamide (which is notorious for the nausea and vomitting effects on Samuel), has been applied. Sam slept thru the later part of the 2 hour drip, without vomitting. Praise the Lord. He is now sound asleep, and we pray that it will be a sound sleep all the way to the next morning.

We are now half way thru the 72 hours treatment. Today, Sam's spirit is a little low, that he has become quiet and a little bit withdrawn. Not his usual chatty behavior. He took some biscuits for breakfast, and then refused to take any solid food for lunch and dinner, except for an apple and a kiwi fruit. However, he cooperated with lots of fluid intake, mainly water and some soup.

We pray that the chemotherapy drugs will take their effects to kill all the cancel cells in Sam's body. We continue to believe that God has already healed the boy, and that this treatment process is a journey of faith and trust in the Lord.

Day 1 of 2nd chemotherapy treatment

We are very early This morning at KK Hospital for the blood check. Thank GOD that Samuel's neutrophil level (WBC) is at 1.03, which is above the minimum level of 1. Sam is allowed to proceed with the chemotherapy treatment, otherwise, we will be send home to wait for another week.

The treatment started pretty late, around 4pm, as the pharmacy seemed to be overcrowded in dispensing with the chemotherapy drugs.
At this time of posting, we are 3/4 way thru Day1 dosage. Samuel has vomitted once, which is much better than our first experience. During the first treatment, Sam has already vomitted 5 times by this stage, so praise the Lord. The drugs is causing Sam to be very drowsy, and he has fallen asleep.

We pray that Sam will be able to rest well in the midst of the treatment. It will be a full 72 hours (3days treatment). Praise God that he only vomitted once so far, and that he will be able to hold up against the vomitting and nausea in the next 3 days.

Prayer requests for Samuel 2nd chemo (26/7 TUE – 29/7 FRI)

Thanksgiving



Thank GOD that we have finally managed to establish the skype account to

Sunday School yesterday so that Sam can continue to enjoy sunday school

Thanks to Suzanne and her team. May God continue to shower this blessing

for Sam to worship HIM.





Thank GOD for showing us HIS love through brothers and sisters who have

showered their love sarcrificially and making this journey more bearable ...

and may many others(non-believers) see HIM at work too ...





Prayer requests for Samuel





For GOD to grant Derrick, Claire and Samuel the peace which HE alone can

provide. Pray for Derrick and Claire to stay calm with Samuel and help us see

hospitalization from Samuel's point of view (eg he told us he cannot bear

the 45 min in the MRI laying still). Help us to anticipate and quell his fears

(nausea and vomitting). Lead us all to health care workers that will also

love and respect Samuel. Pray for unity, respect for each other, love, peace N joy!




Pray that the chemo to have positive effect in the shrinking of the tumour

and removal of the 2 spots in Samuel's lungs. He has been coughing on

and off. Please plead with GOD together with us to clear these spots.

Pray for HIS protection and complete healing.




For God's mercy and miracle that we need not have to go through so many

rounds of chemo to shrink the tumour. Was told by a Pastor Joshua

(his son had osteosacroma another kind of bone cancer) , that after 3rd

chemo, his son was ready for surgery to remove the tumor.

Today, he is back in school ... Praise God.





Samuel's treatment is

a) 6 mth of chemo to shrink the tumour

b) surgery to remove the tumour

c) 8 mth of chemo/radiotherapy to eradicate all remaining cancer cell


For GOD to encourage us to trust and have faith in HIM, draw strength

from HIS word. For myself(Claire), I am claiming Isaiah 40:11 this week.

I do struggle with caregiving and cooking(in particular food - fully cooked??)

For Samuel, he is lost in his world (computers , PSP, TV and books),

may HE guide us to help him to draw strength from the KING's word too.

Incidentally, Samuel wants to invite everyone who support us to enjoy a big

feast with him once he recovers!

For God's provision for a Class A so that both Derrick and Claire can be with Samuel.

Homefront

Caleb will be able to adjust to staying full-time with the LIMs again and be

more independent

Lelia our new helper(very new) will be able to cook for herself and take care of our home

White Blood Cells are cells of the immune system involved in defending the body against both infectious disease and foreign materials.

Neutrophils are the most common type of white blood cell, comprising about 50% - 70% of all white blood cells.

The measure of a normal person's WBC is between 12.5 - 15.0, and Neutrophils between 1.5 - 8.5.

Samuel had his blood check done yesterday back at the hospital and his readings for WBC = 0.99 and Neutrophils = 0.15

We need to be very concious of his personal hygiene as well as the surrounding environment. The boy has a habit of putting his fingers into his mouth, and dislike washing his hands and frequently.

Absolutely no visitors at this stage, so do forgive.

Next tuesday, 26th Jul, 9am is the scheduled re-admission for the 2nd round of chemo.

Meanwhile, we pray that Sam will not succumb to any virus or bacterial infections because of low immunity.

Some pictures for your viewing.....

Sam having computer time this morning.
Saw his thinning hairs?













A picture of his chemo treatment in the hospital.
The chemo drugs are continuously dripped into his body intravenously.












Sam's best friend Ezra visiting to cheer him up before the start of the chemo treatment.



























Can you see the obvious "lump" in his right calf? That is the location of the tumour. We pray that GOD will cause it to wither and die, and that Sam will be completely healed from this disease. Amen.

Dropping Hair and Great Appetite

Samuel has developed a great appetite for food over the last two days. Has been asking for food barely an hour after eating his meals...honestly, its so nice to see him eat....

Another thing that we observed is that he is dropping hair. But he still refused to have his hair cut or shaved.

When we inspected the location of the "lump" on his right leg, we can see that it has physically shrunk, compared with its' initial size. Even Caleb exclaimed that the lump has become smaller. Perhaps its the chemo drug doing its work. Praise the Lord. We pray that the Lord will continue to make it wither and die eventually.

1st week home ... after chemo

Latest update

For Samuel

- thank god that samuel's soft bone marrow test was clear.

This is vital as doctors need to extract his bone marrow
as 'backup' for emergency.
pray for god's protection and healing


- latest blood test indicates Samuel's immunity has plunged
significantly.

pray for all at home to adhere to hygiene standards especially the children
Visitors to be understanding as to why we need to turn them away


- thank god samuel has slowly regained his confidence, started eating and
interaction with people However, spent too much time on computer,tv
and sometimes behaves like a 'king'

pray that we as parents can truly meet all his needs and teach him godly ways.
need His grace and wisdom as we struggle to keep Sam's spirit up and not turn
him to become a spolit brat.


For the family
- to draw closer to God as a family to face the challenges ahead.
Pray that GOD will strengthen our inner man and faith to be victorious in HIM.


- Thank God that Derrick can work from him from this quarter but pray that
God to provide a way out regarding his need to travel and protect his position


- Thank God for support and guidance from a few families of kids in remission,
relatives and friends. Pray that Claire will take up the role of main caregiver well.


- Thank God for our neighbour the Lims who take care of Caleb like a family
member when we are not available. Plan to counsel him with details of
Samuel's illness to prepare him better for lifestyle changes eg
no more bed 'rugby' with sam and 'cheek-to-cheek' sharing with sam

pray that he will be able to understand and cooperate

Once again, thanks for your partnership with us in walking this Journey.
May our Good Lord be magnified through it all !

Prayer Items after 1st Course of Chemotherapy

Urgent prayer request for 12/6/2011 - Pray for Derrick

    -----------------------------------------------------------------------

    Pray for protection, healing  and rest as he has some gastric discomfort and fever.

    Thank God for help provided by sister Wai Yee to accompany us for the appointments

Pray for the Family

      --------------------------

       - May the Glory of our LORD be lifted up in this ordeal and  

       pray for our faith not to faltered... may HIS strength be magnified in our weaknesses

        - God 's word and promises will not returned to HIM void.

Pray for God to lift up Samuel.

      ----------------------------------------

    * For healing and wholeness.  For God to touch him with His healing hands and restore Samuel to total health.

      For God to completely remove cancerous cells from his right calf and his lungs(unknown ducts).

  

  * Pray for positive result from his soft bone tissue test (just done last monday, yet to know results

    * That sickness and infirmity will have no place or power in his life 

    * Cover Samuel with the blood of the Lamb from the crown of his head to the sole of his feet, protecting Samuel's

      body from cancer and infections.  

  

    * Bind all negative thoughts, anxiety, despair, anger and rejection and loose peace and joy.

       Now, he is always on computer and tv.

       Has become very lethargic and demanding. eg take 1 hr to drink 1 cup of water  ( Matthew 18:18 )

     * For God to remove the nauseous feeling and to bring Samuel's appetite back to normal.

     * For God to place in Samuel a desire to drink plenty of fluid and to eat healthy food and to maintain proper bodily hygiene
     * Pray for a close, happy, loving and fulfilling relationship between Samuel and his parents and siblings. May there always
       be good communication between them and may any unforgiveness have no root in their hearts. Help him to love, value,
       appreciate and respect his parents so that the God-ordained tie between them cannot be broken.   Give him a heart of
       forgiveness and reconciliation.

    *  For God to send ('right') saints to minister to Samuel.

       During his downtime, he rejects meeting/talking to his own brother Caleb and best friend Erza.

    *  For Samuel to be open to suggestions, advice, etc from parents, doctors, nurses, other cancer survivors, social workers, CCF volunteers, etc.

    * Give Dr Tan Ah Moy  wisdom and full knowledge to treat Samuel in the most effective way

     * Give Dr Mathew Cheng wisdom to perform the surgery.

       

Pray for protection against infection/complications as this will still down the above treatments. 

The family appreciates concerns from friends. However , please refrain from calling or visiting the family , so as to give the family privacy and peace. This would also  reduce Samuel's  risk  of infection.  We would update this blog as often as we can to keep the information the most up to date.

Samuel 1st Treatment

Hi friends,

Samuel would be admitted tomorrow (03 July 11) afternoon to prepare for a minor surgery for porta cap insertion and extraction of soft bone for biopsy. The chemotherapy starts on Tuesday.

Please support us with prayer on the following :

1. God's presence , unity and peace.
2. Perfect health for all in the family.
3. God's protection for Samuel. Pray against infection and side effects of the tratment (immunity slowsdown 10-15 days later)
4. Readiness in the homefront for Sam's return 5 days later
5. Caleb would be able to adjust in the Lim family.
6. Relatives to be able to stand in the gap to supervise domestic helper.
7. The domestic helper training and adjustment to the family to be smooth and well. Pray that she can be submissive and be teacheable.
8. God's wisdom on the operations team and the oncology team. Pray for good coordination.

The family appreciates concerns from friends. However , please refrain from calling or visiting the family , so as to give the family privacy and peace. This would also  reduce Samuel's  risk  of infection.  We would update this blog as often as we can to keep the information the most up to date.

Preparation For Treatment

Please pray for the family in the following:

• Pray for Samuel to have a good health to start with the chemotherapy.
• The Lord would shower His grace and mercy on Derrick, Claire and Caleb. Pray for safety and protection for the family in their physical and emotional well being.
• Pray the Lord would send to the lee family a spirit of cheers in the midst of their gloominess. Help them to the Lord's goodness day by day , momemt by moment. Shepherd the family lest they stray.
• Pray for all who are taking care of the family in every aspect.  
• Pray that God would watch over the homefront.

The family appreciates that friends do not call them or visit them, so as to give them privacy and peace. This would also  reduce Samuel's  risk  of infection.

House Cleaning in Progress

The family is now cleaning the house.

Pray that the house cleaning can be completed as soon as possible.

Logistics Preparation for the Treatment

Hi friends,

Please continue pray for the family and Samuel for the following:

• The meeting with the Oncologist on Tuesday (28/06) at 3.30pm to check the tumour and confirmation of the chemotherapy dates. Pray that there would be favourable results and that God would grant the oncologist wisdom to prescribe the most effective treatment.
• God's peace, love and unity to all the people affected by changes home setting to facilitate Samuel's treatment. Major house cleaning that will take place today be smooth. 
• God's providence for the smooth hiring of a Philipino domestic helper with some nursing experience, Lelia if this is the person that God would bless the family with.
• Caleb for the adjustment with the Lim family.   

Samuel's condition

Dear friends,

We are very saddened when we heard about Claire and Derrick's elder son Samuel's illness. Samuel is only 11 years old,  active and handsome boy. A tumour was found in his leg and masses in his lungs, he was diagnosed with cancer.  We would want to rally together to support the family spiritually and pray for breakthrough. Claire and Derrick are thankful for all the prayers and concerns that were showered upon them. As Samuel will be starting his chemo next wednesday, they would appreciate if there will be no house visits. This is to reduce the risk of Samuel getting infection. We will provide updates from Claire on Samuel's condition. Please provide your blessings and encouragement to the family in this blog.

Their immediate prayer needs are:

• A trustworthy helper to help with housework
• Strength for Samuel as he goes through the agressive treatment
• Wisdom, strength  and peace for Derrick and Claire as they support Samuel through the treatment.