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The end of chemo

Asa's last dose of chemo was given 6 weeks ago, and he's now largely recovered from the side effects -- he's comfortable, his appetite has returned, and little hairs are sprouting all over his scalp.

I’ve been remiss in sharing this news, in part because as soon as the chemo finished, Asa developed chicken-pox, and we were thrown back into emergency mode.

He broke out in spots on May 28, and at that point, his immune system was still compromised, and we were afraid the chicken-pox was going to be unusually severe.

On doctors' advice, Asa was kept in hospital for 10 days on IV Aciclovir, a drug that slows the reproduction of the virus. 

In the event, the chicken-pox was mild, and the spots didn't seem to cause him much pain.

There was still some systemic imbalance that needed to be sorted out afterwards: Until last week, his potassium levels were still low, and we continued giving him supplements through his NG tube.

But by last Saturday, he had normalized, and we pulled out the NG tube.

Asa, a few days before his NG tube was removed.

Perhaps that would have been the appropriate time to have thrown a party.

It's difficult to describe what a relief it is not to be giving Asa medicine, after 5 months when he rarely went without at least one or two doses of some drug or another each day.

What next?

Many people would like to know whether the chemo worked. 

We may have partial answers within the next couple of days.  

This afternoon we travel to London, where Asa will have two eye exams -- one a vision test at which he's presented with various stimuli and the doctor tries to evaluate how well he sees; and another, tomorrow, when his eyes are examined while he's under anaesthetic.

We have to think about these tests not as the final exams after chemo, but as the first after chemo. 

The reason is that, even if the tumours appear quiescent, there's still a chance they could reactivate in future.

Asa will need exams under anaesthetic roughly on a monthly basis from now until he's about 5 years old (when the risk of new tumour activity decreases).

The prognosis we'll get tomorrow, then, probably won't be for the long term, but "for now".

Thank you!

This is a good time to acknowledge our gratitude for the people and institutions that have helped us get through the last 5 months.  A short and certainly not exhaustive list must include:

1.    Selam – who first noticed the signs of retinoblastoma, and sounded the alarm, and who has done more than anyone to bring Asa this far
2.     The National Health Service – which has given us access to excellent medical care, from specialists to community nurses who visit our home every week
3.    The grandparents, especially Kay and Clive, who have provided support to us all throughout
4.    Other friends and family who have kept our spirits up through the difficult times.

Thank you all!

A few words from Asa

It’s partly a testament to the contributions of all these people, and partly due to his own resilience, that Asa's been developing normally though all of this.

Right now he has a receptive vocabulary larger than we probably realise. He knows the words -- in Amharic or English or babytalk -- for breast ("tuut"), blender ("Nnnnngggg!"), hand-washing ("water-play"), piggy-back ("che-che"), "up", and "down". 

The comprehensible utterances he produces are limited to daddy ("Adada"), mummy ("Mama", which for some reason he says much less commonly), and "There!"

Beyond this, he is a great mimic, imitating sounds -- the noises of the washing machine, cars, coughs and sneezes, and the melodies of familiar songs ("This old man…" and "Twinkle, twinkle, little star") -- and actions like eating, scrubbing, and sweeping: things he’s seen us do a lot.

For a long time Asa was a slacker in terms of chewing his food, but he's making progress on that front now, and in the last few days he's chewed and swallowed bread and raisins.  Biltong next.


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Maybe it's all the to-and-fro'ing we've done on the trains between London and Birmingham for his eye exams, or maybe it's due to some kind of innate fascination with large moving things, but Asa loves trains.

I post these drawings of his partly to cheer myself up. It's been a pretty rough week, watching the US elect a con man as President.

Asa is an American citizen, and in 13 years time he'll be eligible to vote. I'm grateful that he's healthy, and that he stands an excellent chance of living a full life. But I worry about the world that he and his generation will inherit.

Let us pray for wisdom in our leaders, and for strength and resolve for those who resist them in the cause of the greater good.