6/22 update

We have hit some milestones since the last update. Carissa turned 2 months old on 6/17 and 9 weeks old this past Friday. We had another followup to the hematologist on Friday. The visit started with Pamela and I almost getting reported to CPS...only partially kidding...as I noticed the lab technicians getting ready to attempt to insert an IV into Carissa. If you know her history of having difficulties getting IV's you would understand our concern, especially since we had not even done the blood work to do the CBC yet. As I nicely stated that our doctor had wanted to do the CBC before deciding upon a transfusion the tech looked at no one in particular and said that she knew that they should have talked with us first. They called over a hematology nurse who showed us the chart on Carissa's last 4 CBC's and how it was a pretty linear graph indicating that she would be below the threshold and needing a transfusion. I told her I understood the graph but still prefered to see if she really needed to get the IV and they started treating us like people out to second guess them and doubt their ability to insert an IV. They sent us to a different tech who told us we were foolish, that they were the best at inserting an IV, and that we just caused ourselves to have to get back in line when the blood test comes back showing Carissa needing a transfusion.

Somehow God enabled me to keep my mouth shut while in the presence of those openly questioning our judgement and parental ability...and He enabled it to keep it shut and not rush the lab with the news that Carissa's blood count had fallen in some areas but remained just above the threshold for the transfusion. Halelujah! The Retic count was also up 400% from the last test, displaying that her bone marrow is kicking into gear and trying to replace her rbc's and get her hemoglobin count up. Reticulocytes are new, immature red blood cells just produced by the marrow. The white cell count, specifically the neutrophils that have been a challenge, were also in a good area.

Quick update on Colton just to let y'all know that he has healed amazingly. The few people that saw him within the first few days of his accident will tell you that the picture sent in the update that showed his neck did not really show how badly he was banged/scratched up. It is absolutely amazing to now have to really look closely to see any evidence at all of the accident ever happening. Praise God for healing Colt and thank y'all for your prayers for him.

Last Friday's visit with the hematologist was not all rainbows and butterflies as he reminded us of the fact of Carissa's spleen and liver still not returning to normal size and of other issues that could require large blood samples for testing as well as painful procedures for other testing. We are supposed to have an appointment this week for an ultrasound to get an accurate size of both the spleen and liver for future reference to see how they are changing. We go back on Friday again for another cbc.

The last three days have been a challenge with Carissa's first sickness with her appearing to have some sort of cold-like illness. That has caused all sorts of challenges with the basics of eating and sleeping and we are so grateful that Carissa seems to be much improved this evening. She has just not felt well over the past 60 hours or so and was having to be held and comforted the vast majority of that time just to fend off continual crying. She has been asleep now for 30 minutes, which is the longest straight sleep period of the last 3 days.

• Please thank God for Carissa's progress and for her rbc and hemoglobin staying above the transfusion threshold.
• Please pray that the positive trends in Carissa's blood component production and management to continue.
• Please pray that Carissa will continue to grow and strengthen, that her lungs and breathing will continue to mature, and that she will fully heal from the congestion/cold she has been experiencing.
• Please pray that Carissa's amazing progress will continue and that she will be able to avoid the challenges of invasive testing and large blood tests.
• Please pray that the one, true God will continue to receive glory for Carissa's healing and for us to be able to graciously and humbly give the glory to Him when we visit the lab this week and see the technicians that didn't agree with us.

Know that as I share some of the challenges we are dealing with that we are so incredibly thankful to be able to take on those challenges, knowing the grace of God will always be sufficient for us. All it takes is thinking back to just a few weeks ago and how we were longing to have Carissa home, and we are happy to be taking on these challenges. The end of the book of Jude reminds us how fortunate we are to serve a God who can present us as faultness because of the gift of eternal life through Christ, "Now to Him who is able to keep you from stumbling, and to make you stand in the presence of His glory blameless with great joy, to the only God our Savior, through Jesus Christ our Lord, be glory, majesty, dominion and authority, before all time and now and forever. Amen."

Thank y'all so much for your continued prayers. I don't doubt that Carissa's quick recovery from the cold-like illness is directly to many of y'all to praying for her protection and healing. It makes no sense for one having been through what she has been through to be able to get past this that with as little as a struggle as she has. Please keep lifting Carissa up even though you are not getting daily reminders/updates from me to do so.

Yours and His,

Terry