It's been quite a week in the Fraser household, featuring James's liver issues, David going to Joburg for the day on Wednesday and Charis being taken for a precautionary blood test to make sure she doesn't have leukemia!

After visiting the gastro-enterologist to check out what's been happening with James's liver, he recommended discontinuing his anti-convulsant (Epilim) to see if that would help the liver recover. But when they got the blood test results the next day, they found that his liver condition has already improved remarkably! Basically all but one of the enzyme levels were back to normal, and the one that wasn't had improved a fair bit as well. James's paediatrician expects that it should come back to normal without changing his drugs, so there's a bit of a debate now as to whether to stop the Epilim or not - his doctor thinks it was probably a transient viral hepatitis (but not the standard Hep A or Hep B)

Since Sunday Charis has been complaining of pains in her legs and on Sunday particularly she was falling over a lot. With those being some of the symptoms that James had in his legs that led to the leukemia we were obviously nervous! So on Wednesday when James had his appointment with his doctor, Danielle asked her what we should do about Charis. She said for our peace of mind it's best to test, so they went straight off and had a blood test! Charis handled it brilliantly and didn't even cry and James was a great support with all his experience of having needles!

We got her blood results later that afternoon and Charis is clear which is great... the only abnormality was that her white blood cell count was even lower than James's which has been low - this apparently means that she's probably had a viral infection recently.

Charis has been struggling a lot and it's hard to tell how much is emotional and how much is her not being well so it helps a bit to know she has been sick. James has also been quite discontent and struggling - he seems to have perked up a bit as his liver seems to have improved... We do wonder if we've all had a virus and that's why we haven't been well. Whichever way we've felt very stretched both physically and emotionally! Discipline with sick and struggling kids feels like a hard balance to get right...

On the positive side both James and Charis have grown up so much recently - Charis is talking away and her vocab is incredible. James is getting all responsible and helpful and ready for going to preschool next year!

We went to see the gastro-enterologist today as planned to check out why James's liver enzyme levels were high. He said that the most likely reason is that some of the drugs he's on can gradually produce toxicity in the liver over protracted periods of time. This can eventually produce liver scarring etc which is not reversible, but if caught early enough, they can sometimes switch the drugs etc so that it doesn't have a permanent effect.

Over the last month James has been feeling nauseous a fair amount (he hasn't really struggled with this over the previous few months) - often retching at the sight of food and/or not wanting to eat, which has been quite stretching... it's been a little bit better the last week but still there. On Thursday they did some blood tests on him and his liver enzyme levels were quite high, which could be a cause, so tomorrow we're taking him to see a gastroenterologist about it (they told us not to worry or panic! Nice reassuring people, these medical folks are :-))

In the mean time we've had Joy (Danielle's sister) staying with us for the last week which has been lovely for all of us. The next few weeks are fairly full of family and friends coming over - we're going away for a week with all of David's immediate family which will be really special (Andrew and Louise and Mia are about to move to England, Debbie and Jonny and Samuel are visiting from England, and Anni and Richard from Joburg - and his parents)

With all his treatment, James has gotten interested in the different blood cells and how they work. His favourites are the macrophages which are white blood cells that do a cunning trick of growing arms to swallow bacteria etc (see an amazing animation and a time-lapse video).

The other week, he was sleep-talking and was obviously dreaming - he said "My brain can control the macrophage" - and went straight back to sleep

Then on Monday I was reading a book from the library about the Body (again fascinating to him) and there was a section explaining how in the Spleen, macrophages take apart old red blood cells so there parts can be recycled.

We finished reading and he said to me, "Daddy, I'm a macrophage and you're a red blood cell. When you're old and can't work any more, I'm going to tear you to pieces in the spleen"

James had his Bone Marrow Biopsy (which happens routinely every 3 months) and Lumbar Puncture (and monthly intravenous chemo!) last week. The operation went smoothly, although he felt a lot more queasy than usual and ended up throwing up all over the car. David had to go straight off to conduct an interview after dropping us at home ... so it made it interesting for him with the state of the car!!!!) We got the results on Tuesday, telling us that he is still clear from leukemia! The Prof (his doctor in charge of his treatment) explained to us that we are exactly where you should be ... but you've got a long road left to walk! These were honest, but sobering words for us and reminded us of the continued need for prayer in many dimensions! We thank God that He is our strong foundation, never shifting or 'wobbled' by events or difficult happenings!

James has been having leg pains intermittently over the last year. They've tended to be sudden and severe. At times his legs also buckle underneath him. But it's been sporadic and the doctors have struggled to work out what causes it.

The last week he's had more frequent (but not as severe) pains, with cramps and tired legs, and fallen over a few times. He's been limping a lot. It's quite demoralizing for him. We took him back to his brilliant paediatric neurologist today as she wanted to see him when he actually has the symptoms, but unfortunately he didn't seem to be struggling that much when we were there... so she couldn't see anything more than what she's seen before which is inconclusive as to the cause.

We had a wonderful holiday at Volmoed in Hermanus. It's a most beautiful Christian retreat center in the Hemel-en-Aarde (Heaven and Earth) valley that we've been to for church camps and also for holidays from time to time, so it was so lovely to go back there. We also had an afternoon at the beach which was just lovely for James and Charis...

Drama when I was coming back from a work meeting in Fish Hoek on Monday - Danielle was playing with the children on the field and making nests out of grass etc. They went across to another patch to collect some flowers when she noticed a massive snake sliding through the grass (probably about 8 meters away from them). She grabbed the children and took there things across to the other side of the road, but Charis then wriggled out of her arms twice to go and look (she thought it was a joke) and she had to grab her again. She called one of the men working on the farm and so him and a few others rushed to their aid, took one look at the snake, ran and grabbed a pole and dispatched of it. Turned out it was a Puff Adder so was actually very dangerous - I arrived 5 or 10 minutes later and was very relieved to find them all safe.

Had our ups and downs emotionally but was fantastic to have the space for that for all of us, to have good quality time together as a family, and especially for Danielle and I to have time out together in the evenings - we've had more chatting time than we have in ages, and of course we love that!

We came back leisurely on Friday, had breakfast together on the way, and then took James off to his appointment with the paediatric neurologist. She was absolutely brilliant - she asked detailed questions of us, was great with James, and picked up that there is indeed something a bit funny with his gait and his reflexes in his legs. She would like to seem him again when he has one of his periodic pain episodes in his legs to compare that to the base line examination she did with us, and the working hypothesis at the moment is that it could be partially a side-effect of one of the chemo drugs but may have some other complications. They're going to do tests on his nerves in his legs in a few weeks time to see if they can measure an underlying issue - if there is it probably isn't serious (especially in comparison with everything else he's gone through!) but physio etc may be the way to help it.

On Friday night we went out for yet another celebratory meal - we just feel so grateful to God for all he's done for us as a family and for each other, so we're not underdoing the celebration!