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A new strategy

Last Wednesday’s visit to the hospital was the first time Asa has shown distress when he’s seen doctors and nurses. 

As soon as a nurse began to escort us towards the place where his vision was going to be assessed, he started to cry -- anticipating what was coming (stinging eye drops, anaesthetic gas, soreness…).

An exam under anaesthetic (EUA) later that day showed that although his left eye is stable, there is continued tumour activity in his right eye. 

This is pretty much the same story as for each of our EUAs since the end of systemic chemotherapy.

Up until now, the new tumours seemed to be treatable with cryotherapy. But this time the previous session’s cryo didn’t seem to have worked so well. “It  isn't controlling things enough," the ophthalmic surgeon Mr Sagoo told us. 

“We have to think of another strategy.”


The possibility that Asa might receive IAM was mooted back in July, and since then the doctors have debated whether or not it was warranted.

IAM -- intra-arterial melphalan -- involves infusing a chemotherapy drug (melphalan) directly into the eye. It avoids some of the nasty side-effects that accompany whole-body chemo. It also means a higher dosage of the drug can be aimed at the eye.

Possible side-effects are squint, drooping of the eyelid, and dilation of the pupil. Usually these are transitory, but in some cases melphalan can damage the retina and lead to long-term loss of vision.

The long-term effects are difficult to know because the procedure is so new. First developed in New York in 2006, it has been performed in the UK since 2008.

Despite all this, the balance of risks and benefits is better for IAM than for the alternative, which is radiotherapy.

It will be done on Wednesday, September 19th, at Great Ormond Street Hospital.

Walk with Asa

Two days after the IAM, Selam, Asa, and I will walk across London at night to raise money for retinoblastoma research.

We’ll be walking together with other families affected by eye disease.

The money we raise will go directly to the Childhood Eye Cancer Trust (CHECT) -- an organization that supports research on more effective treatments for Rb.

Please consider sponsoring us. To find out more, or donate, see:

Asa looking at butterflies


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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.