Giueseppe came in to see Isita and Marta yesterday afternoon. The trephines are clear. It feels that our prayers (and all of yours – thank you) have been answered. This is the best news and means that the induction chemotherapy phase of Isita’s treatment has been as successful as it could be. Giuseppe told Marta that he had been expecting the clear result because she had reacted so severely to the toxicity of the drugs. This seems to be an area of cancer treatment which is still not perfectly understood. A month ago, when we were discussing how sick Isita was, he mentioned that the link between the side-effects and the efficacy of the treatment was still a matter of debate. But the cancer comes from Isita’s body and has her genes. So it makes sense.

The fact that Isita has reacted so severely to the chemo drugs is the main limiting factor on what happens next. She still has traces of the adenovirus in her blood and gut meaning that we can’t do the stem cell harvest yet. So, we can’t move straight on to high-dose chemotherapy. However, she also can’t go into surgery until her kidneys have tightened up and the level of platelets in her blood have risen. So right now we are facing a temporary blockage.

The quandary facing the doctors is that the main anti-viral drug is bad for the kidneys, in other words the treatments are working at cross-purposes. The most likely decision is therefore to stop treating the virus for the time being and to concentrate on getting Isita fit enough to undergo surgery. As she recovers from surgery they will then switch back to dealing with the virus? If necessary. These decisions are not easy, and Giuseppe is not pretending that they are.

The main task for Marta, myself and all the wonderful ‘aunties’ who come in every day to the hospital is to continue nurturing Isita and to monitor her progress as closely as possible. The general picture is that she is very fit, lively and happy. I am sure it won’t surprise regular readers to know that she has entirely charmed all the nurses on the ward. The other day she told Helen, the ward sister, that she had to say thank you to all the nurses because they were the important people who were making her better. Helen was super-chuffed. “I’m going to tell that to my own children when I get home”, she said. Earlier Isita had persuaded three lovely nurses to dance around her room, waving their arms above their heads like fairies.

At a practical level, we are working with the nurses to count everything which goes in and everything which comes out again. She has just gone 18 hours without an episode of diarrhoea. Dare we hope her system is recovering just when we need it to? At a more technical level, they are monitoring Isita’s platelets, neutrofils, lymphocytes and electrolytes i.e. everything in her blood, and every day things are getting a little bit better. Go for it my darling!