While at the doctors office, his lungs were examined and they were totally clear and an antibiotic was not necessary. The nurse practitioner decided to send George for a chest X-ray to rule out a possible pneumonia. From the pediatrician's office we headed for his X-Ray to be done. After the X-Ray, the technician consulted with the radiologist and a CAT Scan was deemed necessary immediately. George and myself were confused because they were not giving us any reasons for the need of this CAT Scan so quickly. George expressed his concern to the technician and the radiologist brought us into his office to explain to us what was going on before he had the CAT Scan. What we saw was definitely astonishing. There was a large grey area on George's X-Ray, which looked to me about the size of a baseball. It was located mid-chest, close to his breathing tube and extended up into the right side of his chest where his lungs sit. After the CAT scan was done the radiologist again brought us into the office to show us the images. He tried to assure George was this was probably benign but he would still have to see a few different doctors. Upon leaving, the pediatrician contacted my mother and requested for him to head to the emergency room. What was seen by the doctors was alarming and further testing would probably be needed.
We couldn't go to the hospital right away due to the fact that that night was our younger brother, Jared's, moving up ceremony for elementary school. After the ceremony we headed to Stony Brook University Hospital. George was taken right in and the emergency physician viewed the images from the CAT Scan and X-Rays. He was given a nebulizer treatment because of his cough and we were told that due to the location and size of the mass that was visible in George's chest, he would be admitted to the PICU (pediatric intensive care unit). At this point their main concern was that whatever was present in his chest was interfering with his airway and causing the cough, so he would be closely monitored. The Pediatric Oncology Team was contacted and ordered blood work to be done so that the next day they could take a deeper look at was was going on.
Tuesday George went in for a biopsy of the mass. Being that his breathing was already being compromised due to the mass, the oncology team decided not to put George under anesthesia to slow his breathing further. The Child Life staff sent a member into the procedure room with George to help get him through the biopsy. Thanks to them, George was able to be relaxed while listening to "Old Time Rock" on Pandora while the procedure took place. After the sample of the mass was extracted, the waiting game began. Initially, the Oncology Team believed what George had was some form of lymphoma but further testing was needed to come to a final diagnosis.
George was still being kept in the PICU until more answers were presented. Every day got harder and harder not knowing what was going on. We all had so many questions. When the doctors were certain it was some type of cancer, he was moved to the PONC Unit (pediatric oncology). Whatever type of cancer George had wasn't exactly concrete and clear cut so the pathologist would continue to work hard with different tests on the tissue until they were sure.
During this time of waiting, George underwent another CAT Scan to be sure the cancer wasn't anywhere else -- which they didn't expect. They did not find cancer anywhere else. He had extensive blood work -- which showed everything was pretty much in normal ranges. He went for a pulmonary functions test to make sure his lungs weren't being impacted. His lungs had excellent and normal functions. He had a Echocardiogram to be sure his heart wasn't being impacted as well. His heart was perfect, too. All of these tests were necessary because they knew he would need some type of chemotherapy and this was protocol before treatment began. George is set up to be transported to the Cancer Center in a few days for a PET Scan.
The final answer came Friday night. The final diagnosis -- Hodgkin's Lymphoma. George will need about 6 months of chemotherapy. Being that George is healthy otherwise, they expect his body to react fairly well to the chemo and they believe that alone, the chemo will get rid of the tumor. George will start chemotherapy on Monday, June 30. Also on Monday, George will get a PICC line. Down the line the team would ideally like to give George a port for his chemo, but right now it is much too risky for George to be put under anesthesia because of his breathing. The doctors expect the tumor to shrink relatively fast, so after the first round of chemo, a CAT Scan will be done to hopefully see that the tumor has stopped compromising his breathing tube. Once that is confirmed, they will install the port into George's chest so that chemo and blood work will be easier.
While this is all a very shocking and difficult time, after the final diagnosis came and the plan of action was put into place, George feels more at ease knowing what his next steps are. Right now we know that George will need about 4-6 rounds of chemotherapy. That is, 3 days of intense chemo in hospital, 4 days of at home oral chemo and then day 8 will be chemo at the cancer center. The chemo will kill the bad cells as well as the good cells so the doctors will wait a few weeks between treatments to allow the levels in his blood to rise. During the days of his low blood levels, we have to be very careful when it comes to germs. George's immune system will be very low, so during this time he will be limited to contact with friends and family. This is only until his levels come back up and then he is free to do whatever he is comfortable to do, until his next treatment begins. The doctors are feeling very optimistic about this cancer and they expect George to do very well when it's all said and done.
George has been very lucky for his support system though this all. He is happy to see his friends and family daily up at the hospital. He truly couldn't ask for a better group of people to stand by his side though this time.
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