Update from Dominick on Saturday:

Our first outpatient (out of the hospital) meeting was a bit hard to be mentally present for. The results of her final bone marrow count are back and unfortunately Natalie had some Leukemia cells still present, so she did not pass. This bone marrow scan "MRD SCAN" is a new tool on the cancer scene and is accurate within .001%. Previously the test only consisted of scanning for Leukemia cells with the naked eye. Natalie has so few cancer cells that she passed this "naked eye" test but then failed the MRD Scan.

Therefore, Natalie has been placed in the High-Risk/Slow Responder category even though she was considered an Early Responder after the previous count. However, because she has Down Syndrome and because of some extremely favorable research at St. Jude Children's Hospital, we all feel that this treatment plan will be significantly better for Natalie.

To expand a bit further, Natalie is participating in a national research study. The study has specific treatment plans for each individual depending on many factors (one being the MRD Scan). The Low and Medium-Risk categories each have about 4 treatments plans. What happens is a computer randomly picks one of those plans depending on the category that the patient is in, then they evaluate the data to see if the treatment works better or worse for the patient. If Natalie passed the MRD scan the computer could have chosen one of the less aggressive treatment plans for her. Now, considering some of her initial numbers and some favorable research at St. Jude Children's Hospital, all of us feel a more aggressive treatment plan is best though this means more side effects and possibly longer chemo treatments. We are trusting God with this outcome and have found some comfort in knowing that the most is being done for her and we will never have to wonder if we should have done more.

Even still, I felt overwhelmed yesterday with this prognosis. I immediately felt nauseous and almost passed out right in front of the doctors (not usual for me at all). Both Dana and I prayed last night for about an hour or so. I want you to know, it felt so good to simply lay in his lap and ask for His will not ours. We specifically asked God to sustain us for this coming year and to give us the spiritual strength of warriors. This is a hard time but we know that this is only a season in the big picture.

Thanks for your prayers of strength.
We love you all so very much!
The Orlando's

Natalie Orlando

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