Wednesday, November 21, 2007

Not What We Hoped For, But...

We received the news on Friday, while we were in St. Louis. It was in the form of a phone call from my daughter Tova.

My four year old grandson, Reuven, has just had his three month post chemo bone scan and MRI. The results are not what we hoped for. There were new tumors on one of his lungs. One larger ‘penny’ sized one and two smaller ones. The cancer has returned …and very quickly.

Though the doctors are still hopeful… the news is still very hard for our family to take. Obviously this is serious cause for concern. We were all praying and hoping that the results would show that he is still in remission. But… so soon after the chemotherapy, that is unfortunately not the case. The cancer is of the same type of which he was originally diagnosed, Ewing's Sarcoma.

The good news is that it has not spread beyond his lung. His bones are free any trace of cancer. And so is every other part of his body. Doctors tell us that this is a good sign and that additional treatment will not be as long term. But it will be harsh. To look at him now… so healthy, so happy, and so full of life is to heave a great internal cry. It is just too painful.

Ever since Reuven completed his treatments, he has been thriving. He has grown his hair back and has filled out from the ‘skeletal look’ he had during and immediately post treatment. I never saw such a contented child. So well behaved. So utterly happy to be alive and back to a normal routine.

Although the treatments were rough on Reuven, for the most part his spirit was never broken during his nearly year long treatment - including the limb saving surgery.

He has re-learned to walk and his gait is normal. One cannot tell he ever had any surgery. But when he runs, there is a slightly noticeable limp, not that it slows him down or dampens his enthusiasm. His progress was remarkable. Physically, mentally, and spiritually.

He overcame his travails with a grace rarely found in adults let alone little children. His face literally shines now.

My daughter and son-in-law were finally able to go back to a normal life. A life no longer dominated by Reuven’s chemotherapy treatment.

But that was short lived.

We spent Shabbos in St. Louis. Looking at Reuven’s radiant face brought instant tears to my eyes. But, I held them back. I could not…would not… dampen his spirit.

My daughter and son in law are remarkable. My son is law Neil is a pillar of strength as is my daughter Tova. They are determined to do what’s necessary to try and overcome this life threatening disease.

On Monday, Neil and Tova consulted with Dr. Julie Kantor Reuven’s pediatric oncologist. This is the treatment plan. Reuven will have to undergo a new very harsh chemotherapy. This one is so strong that it will destroy his bone marrow.

Reuven will first have his marrow checked to see if it is cancer free which doctors say has a very high degree of probability. If it is proven cancer free, then starting next Monday and continuing through Friday, Reuven will have a two hour daily outpatient IV chemotherapy session. Then he will have two weeks off. His immune system will again be weakened as it was in the last treatment, but not as badly. It will still, however, require monitoring for infections.

After this first phase of treatment, he will be scanned to see if the tumors have been reduced or at least not spread or grown. If the treatment has been affective, he will repeat the cycle.

After the second phase, if the chemotherapy continues to be affective, he will have his bone marrow removed and stored. Then he will hospitalized and have a month long chemotherapy session so harsh that his remaining bone marrow will be destroyed. He will then have his stored bone marrow transplanted. The treatment will at some point require radiation and possibly surgery to remove the larger tumor.

During his 30 day treatment his susceptibility to infection will be so high that he will not be permitted to leave his room at all. Visitors will be limited and great care will be taken to insure that they do not have any colds or other common ailments which could prove very harmful to Reuven.

If all goes well he will hopefully go back into remission and eventually be cured. That is where prayer comes in. This entire process depends on each step being successful before going on to the next. And I pray that they will.

Please Daven for Reuven ben Tova Chaya.