Phase 4: Seriously Stepping Up the Chemo Intensity

The last two months have been surprisingly recuperative, both for Jacob and for Sara and I. Because Jacob has been on a lighter dosage of chemo with very little side effects life almost reverted to pre-cancer normal. He had more energy. He laughed and ran and jumped and climbed and colored and teased. Just like the good old days. He even grew a few thin strands of hair and lost his steroid-chubbiness as he shrank back to his skinny little self. We have been cautiously grateful during this short refreshing season and have often referred to it as the "eye of the chemo storm." But even through this respite we have kept an anxious eye on the horizon as we have been warned about the dark and ominous clouds which have been steadily approaching.

This looming storm, which has just begun for us, is called "Phase 4: Delayed Intensification" (sounds like code for "really long and really difficult"). The doctors tell us that this phase is where they really step up the chemo in order to hit the cancer mega-hard one last time before Jacob enters into the final, and much more pleasant phase called "maintenance" where things will be more akin to what we have experienced for the last two months.

What can we expect during this intense phase? Quite a bit of, well, intensity. We just began this phase on Monday, and the doctors explained that what they are doing for the next two months is knocking Jacob's immune system down to 0. That's right: nothing. Nadda. Zilch. They told us that because of his vulnerability during this time, if he were to get an infection it could be "life-threatening." We didn't like those words very much. They said that in addition to being susceptible to everything, he will most likely become sick because of infection caused by his own body's bacteria (the normally "healthy" bacteria we all have, but with no immunity there is no natural barrier to keep it from hurting him). The doctors said that he will likely be "down and out" for 2-3 weeks of the next two months, that he will likely need to go to the ER multiple times during this phase, that he may need several blood transfusions, and that he may be admitted a time or two as in-patient in the hospital so that he can be closely monitored. I would agree that "intense" is an apt word for this phase.

"Bracing for impact" is a good way to describe our posture right now as this phase begins. As in a lot of things, the anticipation may be worse than the reality. We're trying not to think too much about what could happen while, at the same time, being ready to respond to whatever actually does happen. We're packing a bag and keeping the car running, so to speak, as we anticipate what this all might entail in terms of late nights and hospital stays. We just want to be ready to help Jacob in whatever ways we can as he pushes through this final uphill leg of his journey to be cancer-free.

On a personal note, if we seem somewhat anti-social for the next two months or so, please be assured that it's not you, it's just the inconvenient-to-you-but-life-threatening-to-Jacob germs that you might be carrying. No offense :)

We continue to be grateful for the many warm wishes, phone calls, and petitions to heaven in our behalf. And, from the way it sounds, we will need all of that more in these next two months than ever. God bless you all for your concern, care and comfort.

Let phase 4 begin.