Monday, February 04, 2008

While I Wait…

As I write this essay my grandson Reuven is undergoing surgery to remove a tumor from his lung. Doctors have told us that the surgery is relatively short… about an hour or so. Sitting here in the waiting room of Children’s Hospital in St Louis, I have a chance to reflect on where he’s been, where he is, and where he is going.

The operation, I’m told is fairly routine. Doctors are very positive. Nonetheless, I can’t help but be concerned. This is the third major surgery for Reuven in his very young life. I am somewhat reassured by the surgeons involved that this will be an uneventful procedure. But though I am confident in their abilities, expertise, and experience, I am not comforted.

All I can think about is Reuven’s smiling countenance as he was wheeled off to the operating room. What a trooper this four year old is. He is of course not fully aware of his circumstances or the significance of his surgery so he doesn’t have the ‘worry factor’.

That is to his benefit. To Reuven this is kind of an adventure. His youthful innocence is a blessing to him. But just as surely as Reuven smiles so too do I worry. He is not out of the woods yet. And the ‘big chemo’ is yet to come. Reuven’s bone marrow was extracted last week in preparation for that.

Doctors were disappointed that the tumors reappeared… and so quickly after the last chemotherapy was completed! The first scan right after the chemo was tumor free. Three months later the cancer returned.

Dr. Robert Hayashi, the pediatric oncologist in charge of Reuven’s treatment is being very aggressive and has prescribed an almost deadly dose of chemotherapy chemicals in the hope that it will once and for all ‘flush out’ all the cancerous cells. This dosage will destroy Reuven’s bone marrow. Which is why it was extracted prior to the treatment.

Once the 8 or 9 day concentrated chemotherapy is completed, Reuven will have his extracted bone marrow transplanted. That will be followed by about a three week period of relative isolation in the hospital. This is because his immune system will be non existent. Infections can be deadly. The slightest sign of an infection will require an immediate antibiotic IV. Visitation will therefore be very limited.

Once the immune system kicks back in from the bone marrow stem cells, he will be released from the hospital. Reuven will then receive two 5 day periods of radiation on his lung. Fortunately there were no tumors found on any other part of his body in any of the scans since the first chemo.

Reuven’s school year is over. Though his immune system will begin working again, it will be far from optimal. That will take a full year. And he will not be allowed to go back to a classroom for six months. During that time he will have to be carefully monitored for infections. Contact with children who might have even a common cold is very dangerous for those first six months.

Reuven knows he’s not going back to school. He loves school… but his attitude about it is superb. He takes each new piece of news matter of factly. He is as well adjusted as can be.

That is attributable to the people around him. His doctors and nurses… all of the hospital staff treats him as though he was their own child. It is a very positive and upbeat atmosphere. Then of course there are his unbelievable parents.

But they are not alone in giving Reuven what he needs emotionally. The entire Torah world in St. Louis is like one big extended family. The commitment of the people here both spiritually and materially is nothing short of amazing.

Reuven’s teacher has started calling Reuven twice a day since he stopped going to school last week. She wants to include him in the classroom exercises as much as possible. She plans to continue this until the end of the school year. Eventually there will be a video hookup between Reuven and his class courtesy of Chai Lifeline.

As I write this the surgeon has come out of the OR to tell us that the surgery was a complete success. Reuven is now in recovery. Let us pray that this is the beginning of a full recovery for Reuven Ben Tova Chaya. May God grant him one quickly.