So this morning our platelet count is still only 11,000 despite another platelet transfusion last night. The attending on service has changed and so our new staff is Dr Joseph Mirro, apparently a prior director of St Jude. He graphed out Ibrahim's platelet count to emphasize his lack of response to all our current treatment. So the plan for today, after much deliberation, is to perform the bone marrow biopsy and aspirate and after that perform whole blood exchange (plasma exchange itself is not a possibility in such a small child). We will be transferred to the ICU again to perform this procedure and will be monitored there over night. Please pray that all of this occurs uneventfully.