Diagnosis

The next morning, the 12th of October, we waited for the ER to open. He was to have a bone marrow biopsy/aspirate, a lumbar puncture and a biopsy for the lymph node in his neck. These results would give us a diagnosis and treatment path. The doctor had told us that Jack was in a critical condition, and that time was of the essence. We waited all day, but the OR never became available. I told myself that they were helping another child, one in more danger than my own. We stayed calm, kept asking if there was any news of an available time. Toward the end of the day things were tense. The mass in his chest was still growing, time was felt like it was running out. That evening the doctors came to us with a plan. They said that they felt uncomfortable waiting any longer and they decided to start treating him before diagnosis. Just some steroids to shrink the mass. I asked why they had not started this already. The Doctors were apprehensive because the steroid work so quickly that they skew the results. The danger of unnecessary steroids and skewing the results was much less than the dangers of waiting for the OR to open while letting the mass grow.
 After another night in the PICU, we were in the OR the following morning. The results came back on the afternoon of the 13th. We were asked to meet in another conference room while someone sat in with Jack. They diagnosed him with High risk, stage 3, Acute T-cell lymphoma.  The treatment plan was three years of chemotherapy, give or take. A one month block called induction was the first round. After induction Jack was to be re assessed to see if he was in remission. If not, he would be re-induced until remission was hit. If he is in remission by the end of induction, he moves on. Induction had several drugs and was supposed to be 29 days long. The prognosis for this diagnosis was 75-80% chance of making it to the 5 year mark. After that risk of relapse decreases dramatically. I took notes, asked questions, we signed papers, were given copies of pamphlets, copies of other information, and we went back to Jack. He had already started the steroids, the next day his chemotherapy drugs were started, this was day one of Induction.