Thank you all for your continued kind thoughts and words.  LJMR, you and your family are in my prayers, and yes, we are also scared at what could happen.

In answer to your question, no, my brother sister and I have not pursued anything beyond the current hematologist's recommendations.  Part of this is my father's advanced age and the proximity of the hospital [about 15 minutes' drive].  He has lived a long blessed life and he asks to keep living as much as possible, so we have chosen to make this as simple as possible and not strenuous for him.

Our aim is/was to have my father in his own home for as much time remaining as possible.  The risks associated with cure (inductive chemo and consolidation) were too great at his age.  Therefore we decided just to give him as much time as possible with the most tolerable treatment available (the Vidaza).

I have heard combinations of Vidaza and Mylotarg have induced remission in some patients over 65. However my father's hematologist communicated that this combination could make my father feel sicker than with Vidaza alone.  We decided not to pursue any further opinions because this hospital is nearby and convenient for everyone, they have provided good care and concern so far, and also it is a catholic hospital.  Also the hematologist provided data that suggests 2 year survival rate on Vidaza treatments alone.

The update is that my dad had his last transfusion on Oct 18-19th and subsequent weekly blood tests showed continued good levels of both red and white blood cells.  Last week he was supposed to get Round 3 of Vidaza, but the hematologist left the decision up to the patient because the blood levels were OK.  No one has suggested remission ... we are just going week-to-week.

He stays at home walking about (although less than before), napping, and eating.  He says he feels "well enough"  - - he is looking OK, moving about OK, eating less than before (but he is eating) - - he stays mainly indoors and avoids infection this way.  My siblings and I are helping him and my mother with household chores (we are all within 5-25 miles of their home) and we have access to their accounts/ insurance to help process bill payment, etc.

We decided to opt out of last week's injections.  He may need Round 3 of injections this week.  My sister has him at the hematologist today for this week's blood check.  We are praying he might maintain acceptable levels without transfusion or Vidaza, so my fingers are crossed for the next couple hours (or so) until my sister calls me with an update.

I am a little stressed today because I picked up a cold last week somewhere and am supposed to take him to the doctor tomorrow (if needed) and maybe next Tues too.  I've been able to hold the cold back pretty well with zinc so far but I keep thinking about whether I should cancel for tomorrow (inconveniencing my siblings) or continue on tomorrow and just wear a surgical mask.

Fingers crossed (and prayers) that Vidaza is not needed this week.  Anyway, thanks again to all and I continue to include you all in my prayers.  john f.

3pm update: my sister just called and said my dad's hemoglobin is at 8.1 down from 8.8. last week but still good enough to not need a transfusion or Vidaza this week. The hematologist anticipates he will need a transfusion in a week [based on next Monday's blood work] but he also recommended reducing the Vidaza dosage by 25% and no injections until December - - my dad's numbers have been pretty good for about a month now with no Vidaza or transfusions.

So no worries for tomorrow for me and my cold [the zinc seems to work well if you start using it once you feel any tickle in your throat] ... and Thank You once again everyone for being here ... may God always be with you and bless you ... john f

Hi - To be precise the hematologist did note that it was recommended to continue the Vidaza in order to maintain the control of the white blood cells.  The problem is that there are not many studies available that show anything other than continuous Vidaza injections (every 28 days or so).  They do have data on survival length and that some elderly patients have had remission, but that's about it.  The hematologist could not provide previous examples of where/ when elderly patients stopped Vidaza except after 4-6 rounds to assess progress.

So, to make sure the Vidaza benefit continues, the dosage will be decreased by 25% and he is still scheduled for Round 3 of injections in a couple weeks from now. (the last injections were 7 weeks (49 days) ago)

The hematologist did say that eventually it's possible that the Vidaza could eventually stop being effective for controlling white cells, which means that would be the end.  To be truthful I am hoping that the current Vidaza/ transfusions will allow time for something else peaceful/ painless such as apnea (in his sleep) to happen.

My sister who is the oldest of us three is pretty much taking the lead and my brother and I agree with her that it is better to try and be as close to "normal / natural" as possible - - in other words if the doctor allows chemo to be optional then opting out is probably the better choice if it's not mandatory for survival.  He seems to be better staying at home as much as possible.

With regard to my father's activities, this is where he differs from most people.  Since he retired 20 years ago his preference has always been to stay home indoors or on the porch or in the yard and do nothing and spend no money, regardless of what anyone else (like my mother) prefers.  An example is he still uses 25 watt light bulbs in the house because he "doesn't need anything fancy" (ignoring my mother's preferences).  It has always irritated my mother and in my opinion is pretty selfish because she does not drive and my father is content because my mother basically keeps house.  All he has ever had to do in retirement is eat and sleep with seasonal household maintenance and repair - shoveling/ raking/ mowing/ etc. He argues and yells against any home improvements (even the simplest home depot ones less than $20 that I can do myself) and any improvements to his house ove rthe past 20 years have had to be completed when he traveled to Italy. He drove my mom to the stores and that's it.  For the past 20 years, he refused to drive anywhere beyond 1-3 miles past his house and had no problems inconveniencing my mother or us, his children.

Getting into the details and background of his personality would take many postings.  This is also why I fluctuate between emotions.  To tell the truth he has never been one to provide me with guidance or counsel (ever) and it was people outside my family who have been the best influences of my life. (very few, if any, dinner conversations) Except for clothes, room, and board growing up I had to work and do everything myself with no parental guidance (I am the first in the family ever to get a technical degree in engineering). Even now, nearing the end, both of my parents believe the Golden Rule is for "suckers" so there are difficult moments;  I am reminded that (unfortunately) they are examples of the type of people that I do not want to be.  He is my parent however and he needs help.

So if/when we recommend that he stays inside, he has no complaints about it.  He complains about feeling weak however and general light headed-ness, probably because he is sleeping/ napping so much and watching TV, or doing his favorite hobby of the past 20 years - just sitting and staring out the window.

Again, we continue week-to-week, continue our prayers, hope for the best, and just wait to see what happens.

... and again, good luck to you and your family members and may God bless you and remain in your hearts.  john f

thahks for the suggestion, tex;

I sincerely appreciate the help !!!