A Magnolia Tree Blossoms - Chapter 5

Rebecca's Diagnosis

It was now November; and Rebecca was two years old. The doctor told mother that they wanted to refer Rebecca to hospital for a bone marrow aspirate. This panicked mother, as she had never heard of such a thing; and all she could think about, was would her precious little Rebecca going to be alright. It was a worry for all of us, but somehow my father managed to keep my head above water, as he kept his feelings inside so as not to make a situation seem worse. When we arrived at the hospital, we made sure that Rebecca had settled in nicely, as I began playing with her on the bed we had both sat on, much to the annoyance of the Matron; who did not want us to mess up the bed at such an early time of day. Then the doctor came around to speak to my mother about wanting to do further tests on Rebecca.

"There are two different types of leukemia Mrs Daniels. Leukemia is a cancer of the white blood cells, and it is these blood cells which fight infection; hence why your daughter has been poorly so much, with her catching infections easily." He told my mother.

My mother then began to cry, as the realisation of Rebeccaa's condition had begun to set in. It was then that another mother on the ward came over to mother, and reassured her that things would be fine; and that Rebecca was in good hands. The doctor then continued to explain to her, the importance of her having further tests.

"There are two different types of white blood cells Mrs Daniels; lymphoid and myeloid. Normally these cells which are produced in the bone marrow, which repair and reproduce themselves in an orderly and controlled way. In leukemia however, the process gets out of control and the cells continue to divide, but no longer matures. Until we can get a sample of rebecca's bone marrow, we will not know how to go forward with treatment."

Mother was very distraught by this time, and I was glad that she had the other mother there with her, because I did not know what to do; and I had never heard of leukemia before. No one had told me what was wrong with my sister, apart from hearing little bits when i eaves dropped. I did not know the severity of Rebecca's condition; and every time I tried to ask mother, I was told by the other mother's that she would tell me later. Later on in the day, my father came to the hospital to get an update on Rebecca; and to see how things were. It was then he told me that we had best go home, after he called me his little princess. We left the hospital after I gave Rebecca a kiss and told her to be good for the nurses; and then father and I went to go and get something to eat, before heading back home and getting ready for bed. I jumped into bed, and father comforted me; telling me not to get too upset. I felt safe, and knew my father would always protect Becca and me; and to be able to lie next to him and know he was there soon calmed me down from crying.

"Daddy, what is wrong with Becca?" I asked

"Rebecca has leukemia Amanda." He replied, as he cleared his throat and then held my hand.

"What is leukemia?" I asked

"Sorry Amanda, but there is no easy way to explain this to you. Rebecca has cancer. Leukemia is a cancer of the blood sweetheart, and the hospital are doing there best to help your sister get better." He replied, now in a flood of tears, as he cried uncontrollable

I then turned to father, where I placed my head into his chest and cried my eyes out. Telling him that maybe they had got it wrong, and it was just another chest infection she had caught. My father then telling me that he wished it was so easy as that, as he too cried as he held me tight. This was the first time that my father had cried in front of me, and it was the first time; but not the last that we comforted each other. The next day when father drove me to the hospital, i walked over to mother and gave her the biggest of hugs; as I told her I knew what was going on, as daddy had told me the night before. I told her that I loved her very much, as well as Rebecca; and that I would always be there for them. Mother then told me that I was a very special young lady, and then told me to dry my eyes as the doctor was due to call in on her. When he arrived, he explained to mother that the procedure had gone well, and they were just waiting for the results to come back from the lab.

"Mrs Daniels, Rebecca has acute lymphoblastic leukemia; also known as ALL. This is an overproduction of immature lymphoblastic cells called lymphoblasts, or blast cells." He told her

"Ok; and what do these cells do doctor?" Mother asked

"Mrs Daniels, the immature cells fill up with bone marrow, and then stop it from making healthy blood cells. As these cells are immature, they cannot work properly and this puts the child at an increased risk of infection, as we have already seen these past few months. Symptoms like bruising on the body, and anaemia are caused by the bone marrow's inability to make enough healthy red cells and platelets." he replied to her.

"And what about treatment doctor, will my little girl be ok?" Mother asked again, now beginning to cry as she was trying to take things in.

"There are different types of childhood leukemia, and these are identified according to the lymphoid cell affected; and of course the stage during its development, at which time it becomes acute lymphoblastic leukemia. The affected lymphocytes may be either precursor or mature." he again explained, which had mothers head spinning like crazy, as she told the doctor she did not understand.

"Prescursor cell leukemias, may involve either two types of lymphocyte. B-cells or T-cells. B-cell acute lymphoblastic leukemia is further divided into three catorgories; null-cell, common acute lymphoblastic leukemia; and pre-B acute lymphoblastic leukemia. Common acute lymphoblastic leukemia, is the most common type of childhood leukemia accounting for up to 70 per cent of cases. Knowing which type of acute lymphoblastic leukemia Rebecca has is very important, as it helps us work out the best treatment for her." he told her.

Mother was now in a panic, as her only concern was that of Rebecca being able to survive this; as she asked him if she was going to be ok. The doctor told her that we were not in to 1960's where it was uncurable; as we have progressed since then, and that it is a well known fact that the survival rate of children in Rebecca's condition is almost 70%. That survival is highest in children who are diagnosed between the ages of 1 and 4 years of age. Mother then asked about treatment for rebecca; and again the doctor told her it all depended on the condition and stage of Rebecca's leukemia. After a long wait at the hospital, the doctor finally came around to see mother, and it was there that he gave her the diagnosis. He told her that it was confirmed that Rebecca had acute lymphoblastic leukemia; and that they would be starting treatment the following day. Mother asked about the treatment, and how long it would take; where the doctor explained that 75% of children can now be successfully treated, and that treatment is long and gruelling. Her treatment would last for about 2 years, and she would be started on a combination of chemotherapy drugs and steroid medicines; which will be given to her in stages. Mother then asked if the treatment would work, where the doctor told her that they did not know until they tried. As the initial aim of the treatment is to achieve what is known as a state of remission. The state where most of the leukemia cells have been killed; which allows the production of normal blood cells to once again resume. Rebecca was put on her first stage of treatment, which involved several drugs in combination, and would usually last between three and eight weeks, depending on how quickly Rebecca responds to her treatment. Then they would have to leave it for a while, so that Rebecca's body could be given time to recover, which would minimise the risk of treatment related complications. We were told that Rebecca would be tired at first, but she would soon be well enough to resume her normal everyday activities; and if she was at school, then they would have no problem with her returning. She would be closely monitored by the hospital at this stage. She was also advised that there could be side affects, and the most common one's included vomiting and nausea, hair loss, reduced resistance to infection, some bruising and bleeding; and of course tiredness and looseness of the bowels. Mother flipped out at that stage as she told the doctor that it was not a lot to worry about then.

Over the coming months, Rebecca had a favourite nurse called nurse Rosie, who was always there to help. Rebecca often called her Rosie, which she did not mind, and when she came into the room Rebecca was always the first to run into her arms. When she was ready for her treatment, it was Rosie who was with us throughout, as she put us all at ease. Rebecca was a natural, as this did not affect her. She was much stronger than mother and I, as we had to hide our feelings; yet Rebecca took each procedure without complaint, and it was Rebecca who made us feel alright with her bravery and strength that she had.



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