Date: Sat, 27 Apr 2002 17:57:28 -0400 From: Rory M Subject: A Family chapter 2 A Family By Rory M. Chapter 2 "Mr. and Mrs. Elliot, please take a seat. I'm Dr. Hastings and will be your son's chief oncologist during his treatments here at CHOP. I just want to go through what all of this means and what is going to happen in the future," We both nodded and took seats in front of the desk in the small office. Avery was in the next room with a nurse playing with a stethoscope being prepared for more testing. So far we had been told that more testing was needed to determine what kind of Leukemia it was, that he would be in the hospital for as little as 3 days or for more than 6 months and that we would be meeting with our specialist team shortly. This was all said at the registry desk... "Your son is going to need some intensive testing today and tomorrow, and hopefully by the end of today we'll be starting him on chemo. What we need to find out are your son's healthy platelet, white blood cell, and red blood cell counts compared to his abnormal leucocytes. The cancer is basically producing mail formed or immature white blood cells, which are also preventing platelets and red blood cells to function properly. Our concerns are that his ANC levels don't fall too low and that his hemoglobin is at a good level. These will be tested every day at first, and periodically when his numbers improve and he heads into remission. "We first though have to diagnose which form of Leukemia we're dealing with. If it's the most prevalent, which is acute lymphoblastic leukemia, he has much better chances. Therefore, we're hopping that he does have ALL. If it's not, we'll go over our options with AML and CML if we need to. "Right now we're prepping Avery for more blood testing. He'll also need a bone marrow sample and a spinal cord tap, during which we will hopefully be starting chemotherapy, which is a medication plan that is used to destroy as many cancer cells as possible. "Right now a social worker is talking with Avery and will be in to see you shortly, I want you to meet with his team of oncology nurses, doctors, hematologist as well by the end of tomorrow. I want you to look through the reading you were given and ask any of the staff or myself anything that you have concerns about. We're going to try to make your son's stay as comfortable as possible, but within this realm it is difficult. We're setting up a room now for his stay, and we'll be briefing you throughout on going procedures and how to care for Avery. Right now though I would like for one of you to be prepared to stay with him during the bone marrow extraction and then the spinal tap. Both of you may, but we prefer just one." "Noah?" Maren was in tears, I knew what she was asking before she had to say it. "I'll go don't worry. Do you want to call Liam and brief him on what's going on?" "Very well," the doctor said, still in his professional but calming voice, "both of you can spend some time with him now though, the blood testing you both can stay for." We walked down the hall to the playroom in which Avery was playing with a social worker. I still couldn't come to the realization as to what was going on. Maren had already spouted that it was probably because of the chemicals I was exposed to at the water works. I'm a supervising engineer for Philadelphia water works, I was exposed to certain chemicals I suppose, but they weren't dangerous. Especially considering they were placed in the drinking water of the greater region. I didn't argue her though. I was more concerned with Avery, as I think we both were. We walked into the playroom to see him already in a hospital smock. He was very happy to see us as he got up immediately to come towards us. "Daddy I want to go home now, can we go home?" his eyes were pleading. He had been told what was wrong but he didn't understand it. He knew he was sick. But he hadn't been in a hospital since the first few days of his life, and it might be the next few months. "Sweetie, we're gonna be here for a few days, ok? But it'll be ok, me or daddy will be here most of the time." "I don't want to stay...I want to go home. I didn't do anything bad, I want to go home," his little voice was whiney and tears started to well up in his eyes. I picked him up and cradled him to my chest as Maren came in and ran her hand up and down his back. "You didn't do anything wrong, Avery. You're not being punished. You're just very sick. We have to stay here so you can get better, ok?" I tried to keep my voice even but had to stop. I kissed him on his forehead and looked into Maren's eyes. Before she could say anything, however, a nurse came into the room just as the social worker left. "Hey Avery, how yah doing?" She was wearing a bright uniform with teddy bears all over it. Every thing about her was colorful and eye catching. She was a little older and heavy set, but you could tell that she was a professional when it came to kids in this place. Just her introduction to Avery made his mood brighten a little. I hoped this was going to be one of his oncology nurses that the doctor had mentioned, "We're gonna go to a room down the hall and get some stuff started. Your mommy and daddy can come to. You'll get some happy medicine if you want it, too." "Happy medicine?" he asked with comical disbelief. "Yep, but only if your mommy and daddy think it's ok. You ready?" Nurse Peters (we found out her name moments later) led us down the hall to a room with three exam tables, many iv stands and walls stocked with medical equipment, bottles of liquid and pills, and random pictures drawn by children. When we entered the room the nurse drew out a kit and placed it on a table next to one of the exam tables. When Ave saw what she was doing he immediately tensed and began demanding to go home again. Maren insisted that he be brave and sit on the table, but her words went unheeded as he clung to my arms as I sat him on the table. "I can give him this spray that will numb the area, the 'happy medicine' does wonders," the nurse said to us as she laid out the blood taking kit, "Do you want the happy medicine, Avery? You won't feel the ouchy." "NO!!! I WANT TO GO HOME!!" he started sobbing. "Honey, it'll be really quick. Two in your arm and one in your finger and they won't hurt that bad. I'm so good you won't even know what's going on." "Come on Avery, you have to have them. I know it stinks but it'll be quick and then you can go relax, ok?" Maren soothed. He whimpered out that he still wanted to go home. "Alright Avery here's what we'll do. Which finger and arm do you want the happy medicine to go on?" "Is it gonna hurt?" he sniffled out as he still clung to me. "Nope! It'll tingle a little. All you have to do is look at mommy and daddy and you will never feel it, ok?" she took out a small spray bottle with colorful happy face stickers all over it and sprayed his inner left elbow, his left index finger and his right wrist. He calmed down for a few minutes as she prepared the rest of her kit. I in all honesty was impressed. Avery was usually a basket case in situations like this. I'm surprised he wasn't clawing for the poor woman's eyes. "Alright, now look at your mommy ok, and she's going to count to ten with you," she gave me a look that signaled me to hold onto him while Maren held his other hand and distracted him. She rubbed a cotton ball over the area and proceeded to insert an IV tube and draw blood from it. Then she taped it down and attached the tubing from the stand to his arm, all in the span of Maren and him counting to 12. He didn't even flinch...I was shocked. "Alright Avery! You were so good!" he looked over from his mother to his arm and immediately started to cry, "Oh come on now, that was the hardest part, you're almost done," he sniffled and buried his face into his mother's hand that was resting on the opposite side of him. "You know, I think you did so well with that we don't have to do the finger prick." His face brightened, "Me and mommy are just going to switch sides for one little one and we'll be all done." It wasn't a little one, though. She had to check his blood gas...I remembered these from when I had pneumonia in college. They're not pleasant, and the needles seem to be thicker. He screamed from the top of his lungs and started to thrash like I remembered. The crying didn't stop until long after that. "Alright Avery, you're all done. I'm sorry kiddo. Hey, why don't we go see your new room now and let your mommy and daddy talk to the doctors, ok?" ~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~ "Why are you going to give him the local anesthetic after the spinal fluid is extracted, why not before?" Maren was angry already "Because we need a pure sample to make sure that the cancer isn't affecting his brain or spine. When we go to get a marrow sample, he'll be getting the local anesthetic. It will be very similar to that of an epidural, which you may have received when you were in child labor. He'll receive a sedative and pain killer before the spinal tap. So he'll be awake but much more comfortable. He will feel some of it, but he won't remember the procedure after, and he won't feel us extracting the bone marrow from his hip. Avery has already received Valium to calm him down and we'll administer the morphine we'll add shortly. The procedure should go underway by 2pm. Do you have any more questions, Mr. Elliot?" The doctor was to the point. I admired that. "My husband will be able to stay with him the whole time, correct?" "Yes, he'll just have to wear a mask and some sterile gear." "That's fine with me, can we go spend some time with him before this all goes under way?" I was anxious to get out of the hallway and back into my son's hospital room. He was still upset about everything that was going on. "Of course, we'll have a nurse in shortly. I also suggest that you contact the psychologist that the oncology department has, with situations like these we ask all parents to consult her," and with that the doctor left. Avery was half asleep, curled up into a ball on the over sized hospital bed. I walked over to him and placed the oxygen mask back over his mouth and nose, gently. He was tired from the traumas of the past few hours and the sedatives he had been given. My heart broke to think of what was to come. "Do you want to call your sister or anyone? I'm gonna call Liam and update him. Do you want the kids to stay with him a few days?" "Fine. But I don't want him to tell them, I want to. It's not his responsibility." "Alright, we'll tell them together tomorrow?" "Alright, I'm gonna see if my sister can take them for a while, they all go to the same school." "Maren, Liam can handle it, he's like a second dad to those kids. They love him." "Well, since you forced him on them I guess they didn't have much of a choice." "I never forced him on them or forced him into parenthood. Why don't you accept that fact that he plays a big roll in their lives. He's going to be at this hospital and taking car of Ave almost as much as we are, you need to start giving him a chance," I was trying to keep my voice low. "You're going to make a circus out of this, too? Well, I don't think it will work. I doubt the hospital allows non-family members." "You know that we have power of attorney over each other. If you didn't keep stalling on letting him adopt the kids we wouldn't run into problems like that." "Oh, so if I got remarried would you allow their 'other' stepfather do the same." "A marriage makes it by law, it's less complicated. I'm just trying to do what's best for..." "You never do what's best for them, you do what's best for you!" We continued to bicker like that for a few moments until the nurse came back and asked us to step outside the room. I felt ridiculous, I'm sure we both did. The same kind woman that had been such a great help with Avery an hour before now turned a different corner with us rather quickly. "It's always difficult with people like you." "What do you mean, 'people like US?" Maren was on the defensive once again. "Divorced parents. Usually they come together and can cope with it, but people like you make it all the much more hard. Don't you realize that you're putting added stress on that little boy? He needs both of his parents to be supportive and advocate for him instead of bickering and fighting around him. It makes his recovery more difficult. You two need to grow up and stand together for that child. If you can't do it then I suggest you work out a schedule, because I can't allow it with my patients." "She's right, Maren." I was so ashamed of myself. "Listen nurse, I know you have the best intentions but so do we. We would never do anything to harm Avery, especially myself," she glared at me like I was a child beater, "We'll try our best, but you must forgive me for being stressed. This is a lot in a few hours. I'm really not used to being thrown into such a horrible situation and having to live through it with little support system from his side," she again pointed at me. "Ma'am, as far as I see it he's been here all day and isn't on the way out the door. Maybe you need to rethink your sob story. For now, I've got to take Mr. Elliot to get prepped. I'll be back to get Avery momentarily." I was lead by the nurse to a small room where I had to wash my hand and arms from the elbow down, put a smack over my clothing, and wear a surgeons mask and cap. The nurse then left me in the room to go get Avery. A few minutes later I was in a similar sterile room like the one I was in earlier, there were three doctors and two nurses, and little Aver was laying on his side, oblivious to a lot of what was going on around him. In honesty I was glad that they had sedated him, I don't know if I could have taken it if he wasn't. They reassured me that he wouldn't remember any of the procedures of the rest of the day and that he will bounce back quick. The whole spinal tap didn't take that long, maybe a few moments. I held his hand during the whole thing. He cried a little, but it was nothing compared to earlier in the day. I cried with him. To think that this was going to be the next few years or months of our lives was not what I wanted in a million years. I wanted to be lying on that table. I would rather die of cancer than watch my little boy do the same. I would rather even give full custody of all three to Maren and never see them again as long as they were healthy. The bone marrow extraction wasn't bad. He couldn't feel a thing. He was a little scared, but it didn't take long. Within 45 minutes we knew in fact that it was acute lymphoblastic leukemia, and he has a 98% chance of entering remission. What was worrisome was that his blood counts were low, which in short meant that we were dealing with a more powerful chemotherapy regiment and a longer hospital stay. By six o'clock that evening he was retching his little body into exhaustion. It wasn't so bad at first. He complained that his stomach and eyes hurt, but when they served dinner he took one whiff and it was all over. He slept fitfully after his stomach calmed down, and I took that opportunity to go to my house to grab some stuff, and then to Maren's house to get some of his toys and clothes, along with some stuff for her. I was making an effort to be on the same side as her, to support her and Avery...it was just a long day. ~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~ "Hey, how is he, what happened? What did the doctors say?" Liam jumped off the couch when I opened the door and came to my side. "I... umm... it's leukemia. It looks good though; it's just going to be intense for a while. Umm... where are the kids?" "They're both in bed, it's after 10. Honey why don't you take a breather, you look like hell. Have you eaten?" I plopped down on the couch and started to bawl. I had never felt so helpless and out of control in all of my life. I cursed myself for feeling less fortunate. In 34 years of living the most traumatic thing that ever happened to me was getting that blasted divorce. I should have been so grateful!! The next thing I knew I was sobbing into Liam's chest as he held me on the couch. He too was crying, but silently. I composed myself enough to look him in the eye. "Umm..huh. Do the kids know?" "No, I didn't have the heart to tell them, I don't think they would understand." "OK, that's fine. Maren wants to anyway. I actually should be getting back to her." "Eat something, please?" "I'm really not hungry." "Eat anyway, I'll pack up some stuff for you while you do." I sat at the dining room table and ate the platter that had been saved for me that evening. I didn't realize how hungry I was. Within 15 minutes I was packed up and kissing Liam goodbye for the hospital. I had him prepare a little care package of food for her as well, I'm sure she hadn't left that room since I left a little over an hour ago. When I showed up in the room she was curled up in a chair next to the bed reading through the pamphlets that Dr. Hastings had given us. She looked tense, more than usual, but I probably did as well. "Want some chicken and rice? I brought you some from home, and I got you some toiletry and clothing. Has he woken up?" "Thanks... you didn't have to do that. Once, he just 'wanted to go home' and fell back to sleep shortly after. His fever went down a little, though." "How are you doing?" "Why do you care?" "Because contrary to your belief, Maren, I do care." "I'm ..I'm sorry, I'm just a little snappy today, you know?" wow, she apologized. "I know, Mar, I know. I was just thinking about what that nurse said today, and she was right. I don't want him or any of the kids to see us fighting, but now we really need to stick together. I'll try if you'll try." "I'm trying! But it's not easy, Noah, it's not. You broke my heart, and I still can't stop hating you for that." "Then try harder to forgive me. It's been over 3 years, and we have to move on for Ave." "Can you just give me time, maybe a little space? I can't hate you for all this time and turn around and be a team again, things have changed. You left me alone, and not only that for a man. How am I supposed to shrug that off?" "I wasn't involved with Liam until the end of the divorce settlements. And why can't you see that I did some of this for you? You knew we weren't happy. We fought on almost a daily basis. I couldn't be happy living that way anymore, and neither could the kids." "Then answer this question for me. Why all those years? Why have kids just to put them and me through that if you knew all along?" "Because I wanted to get married and I wanted kids. I loved you and them and I still do with all of my heart. I was stupid then, I denied the fact, I admit. I just didn't think it was right not to. I know it was probably the biggest mistake of my life to do that to you and I'm forever sorry, but you know I am, why can't you see that?" "Because I still loved you." "I never stopped loving parts of you, I just couldn't love you as a wife anymore." "This chicken is cold," she poked at the chicken in front of her and gave me an accusing jab with her fork. "Wha? Umm... there was a microwave in the lounge, want me to heat it up?" "Nah, it's ok, I need the walk anyway. But Noah?" "Yeah, Mar?" "Just give me time." "Whatever you want."