We're at NYU for chemo round three. Andrew had a nice few days leading up to today. Yesterday, we took Vivian to church, went to brunch, and had friends over for a pool day. Pool days and less-awkward showers are now a reality because his picc line was removed and IV antibiotic treatment ended last week. Saturday morning, we took Vivian and Wesley to the park together, which we haven't done since the day before Andrew was diagnosed in June. Andrew's cold sensitivity went away, and he pregamed this morning with an ice cream sandwich.

We learned in his pre-chemo appointment that his platelet count is low, dropping significantly since last time. Low platelets increase the risk of bleeding, potentially made even worse by his blood thinners. The solution is to decrease the dosage of one of the chemo meds, irinotecan. This is the same medication we discussed decreasing earlier because of severe side effects, but ultimately kept stable thanks to better symptom management.

Andrew was on the highest-possible dosage of irinotecan—something the vast majority of patients are not prescribed—so there was room to decrease it. But we are still bummed because it felt good (emotionally, definitely not physically) be as aggressive as possible. On the bright side, it's better to have this option vs. delay chemo. Please pray with us that his levels are much better next time. In our ideal world, he'd go back up to the max dosage. More realistically, a rebound would allow us to continue with the treatment as planned at the new dosage. The oncology NP assured us that consistency in treatment is more important than dosage alone.

While that lab result was disappointing, we are celebrating another. Periodically, his doctor tests his CA 19-9, a(n imperfect) cancer marker test. In theory, a low or decreasing result means there are no tumors or treatment is working. High or increasing levels could indicate a large disease burden and/or treatment is failing. Andrew's oncologist warned us not to read too far into any single result, as it's more helpful to look at trends from serial measurements. A normal result for a healthy person is under 40ish. On June 3, his CA 19-9 was 3,553. On June 12 (before chemo started), it jumped to 4,709. Today, 989. We are taking a victory lap on that one.