Dear CCAM Partners and Friends,

Although Buntheep's progress that we reported last time continues to go forward little by little, nevertheless a new emergency has emerged. Exactly what is going on or what to do about it has not yet been determined, but the CCAM physician Dr. Andres and Dr. Aldana and Dr. Roy in Jacksonville have already begun consultations by email. So far, there are more questions than answers. Please pray!

Ever since the aborted Gamma Knife procedure at the end of March 2008, we have noticed a gradual change in the shape of Buntheep's forehead, which had previously been perfectly restored by Dr. Roy after the 20-hour surgery performed in early December 2007. However, Buntheep's charming new hairstyle of "bangs" covered her forehead and hid the changes. But during the past week, Buntheep became concerned about the continued changes she observed in her forehead and brought the situation to my attention.

Upon visual inspection without the hair cover, it seemed to me that, from the bridge of her nose upward to the middle of her forehead, the bone appeared to have "sunk." On Thursday afternoon, Dr. Andres performed an ultrasound exam on Buntheep's forehead, finding that the sunken area was actually missing the bone altogether!

The drug Calcitonin might possibly be responsible for leeching the bone, but to avoid that, we have been giving Buntheep oral calcium and Vitamin D supplements every day. We wonder -- are we facing another one of those seemingly impossible situations, that Buntheep needs the Calcitonin to continue shrinking the tumor, but at the same time might need to stop taking it to preserve her bones? Or maybe the bone loss is a delayed side-effect from the radiation? Or something else?

Another symptom that has appeared in the last couple of weeks is the leakage of fluid from her nose once in a while at nighttime. This fluid might be leaking from her brain (CSF), or dripping down from where the bone is being dissolved, or something else. Now we are attempting to collect that fluid to determine its origin through laboratory examination. The problem is, the laboratories available to us in Cambodia cannot perform some of the sophisticated tests required. In addition, all labs will be closed for the upcoming week due to a national holiday.

In the meantime, please pray that the deterioration of Buntheep's bone will stop and that God might even restore it again. Pray that we can find a way to test the fluid discharge to discover its origin. And please pray that God will give these doctors supernatural wisdom to advise us during this new emergency.

In His Hands,
Gioia and Buntheep

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