Warriors and Survivors -55

Children Cancer Stories by Rukh Yusuf - Blog # 55

 

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have been working in Pediatric Oncology unit of a public hospital for several years. The mission of this blog is to bring to you the real-life stories of child patients suffering from cancer. Cancer is still a difficult disease to handle and treat. However, when it strikes the children, some so young that they cannot even speak, their agony is beyond expression and words. Let us pray especially for children suffering from cancer for early and complete remission. May Allah shower His Merciful Blessings upon them. Aameen.

Mahnoor is eight years old sweet child. I met her last week when her chemo dose had some issue and she was worried for her chemo dose. She is very innocent looking thin child. She was wearing scarf which was adding innocence to her face.

Mahnoor is patient of acute lymphocytic leukemia, she is on relapse protocol that is heart breaking. Poor souls and their families very hardly bear treatment first time and when they recover this disease comes back in some other form.   Though she is admitted again but she does not seem worried or frightened. She was with her aunt and was looking more vigilant than her aunt.

Mahnoor also wants to go to her home as soon as possible like all other admitted children. She knows her chemotherapy protocol and counts days herself when she can go home after completing her doses.

When I met her again, I was surprised to see that she was crying.  I had an image of her bravery, so I was concerned to see her crying. When asked why she was weeping, she replied that her Dado (grandmother) has not come yet. She was missing her grandmother and was weeping with tears.

She lives in joint family with her grandmother and an aunt. She has younger siblings to be taken care of, so her mother has to do a lot at home. Father has to earn livelihood, the reason he could not come too. She is lucky to have the option of dado and Phupho who can go with her for treatment. In this visit Dado was unable to come and Mahnoor was missing her when she was in pain.

Sometimes children look normal apparently while they are suffering actually. Mahnoor has similar case. She looks like a normal pure soul wearing hijab. But being a relapse case, she is going through a lot already. I observed another good thing today, due to long and cumbersome treatment children and mothers develop some bonding with each other. They take care of each other’s children in need and otherwise. It is good to see them helping each other and realizing their pain.

A mother whose child had passed away, used to come in Oncology ward to take care of other fellow children of the same room. Pain has tied them strongly; they can feel others’ pain exactly in true sense. It is true that pain teaches us a lot.

Mahnoor and her Phupho also take care of other fellow children in their room. It is heartening to see them helping others when they are in such a grave situation.

 

We pray for the ease of the Mahnoor and her family and the complete health and recovery of all warriors who are suffering with their families.

May Allah ease and cure all patients and cancer warriors.

 

 

Note: Names have been changed to protect identity

 

Warriors and Survivors -54

 

 Children Cancer Stories by Rukh Yusuf - Blog # 54

 

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have been working in Pediatric Oncology unit of a public hospital for several years. The mission of this blog is to bring to you the real-life stories of child patients suffering from cancer. Cancer is still a difficult disease to handle and treat. However, when it strikes the children, some so young that they cannot even speak, their agony is beyond expression and words. Let us pray especially for children suffering from cancer for early and complete remission. May Allah shower His Merciful Blessings upon them. Aameen.

 

We have discussed Thalassemia in couple of blogs already but when I met Mohsin Ali and his parents in such a critical condition, I decided to write more about this severe disease.

Thalassemia is an inherited blood disorder that reduces the production of functional hemoglobin (the protein in red blood cells that carries oxygen). This causes a shortage of red blood cells and low levels of oxygen in the bloodstream, leading to a variety of health problems. There are two main types of thalassemia, alpha thalassemia and beta thalassemia. Signs and symptoms vary but may include mild to severe anemia, paleness, fatigue, yellow discoloration of skin (jaundice), and bone problems. Beta thalassemia is caused by changes (mutations) in the HBB gene while alpha thalassemia is caused by mutations in the HBA1 and/or HBA2 genes. Both are inherited in an autosomal recessive manner. Treatment depends on the type and severity of the condition but may include blood transfusions and/or folic acid supplements.

The signs and symptoms vary depending on the severity of the thalassemia. For example, people affected by milder forms of thalassemia can develop mild anemia or may have no signs or symptoms. Intermediate forms of thalassemia can cause mild to moderate anemia and may be associated with other health problems such as slowed growth, delayed puberty, bone problems and/or an enlarged spleen. People with severe forms of thalassemia may also experience severe anemia, poor appetite, paleness, dark urine, yellow discoloration of skin (jaundice), and enlarged liver or heart.

The two main types of thalassemia, alpha thalassemia and beta thalassemia, affect a different part of hemoglobin. In general, thalassemia is inherited in an autosomal recessive manner, and the inheritance can be quite complex as multiple genes can influence the production of hemoglobin.

The best treatment options depend on the severity of thalassemia. People affected by a mild form often need little to no treatment, while people with intermediate to severe thalassemia may require frequent blood transfusions, iron chelation therapy (treatments to remove excess iron from the body), and/or folic acid supplementation.

Children with severe beta thalassemia need frequent blood transfusions and due to this blood, excess iron is stored in different body organs leading to serious complications. Even with good chelation therapy, iron stores sometimes cannot be completely depleted.

Usually, thalassemia patients are being treated on outdoor basis but when some child develops complications, he/she is admitted to hematology oncology unit. Mohsin Ali is admitted due to his sever complications. He is eleven years old only male child of his parents. He has two sisters.

His father is laborer and the family belong to Pakpattan, A really brave family who is striving hard for the treatment of their only son since his initial life.

Mohsin Ali is extremely weak and pale. He is having blood in his stool with lethargy and low oral intake. His ferritin is too high to be controlled. He seems sick and we don’t have words to council parents about the situation of their only son. This is the hardest part for any healthcare provider to guide and inform about the condition and sickness of the children to their parents.

Mohsin’s both parents were with him, struggling with everything they could do for their dying child. Such a heart-breaking situation and when you know you cannot do much for the cure or ease of the poor child.

 

We pray for the ease of the Mohsin Ali and his family and the complete health and recovery of all warriors who are suffering with their families.

May Allah ease and cure all patients and cancer warriors.

 

 

Note: Names have been changed to protect identity

 

Warriors and Survivors - 53

 

Children Cancer Stories by Rukh Yusuf - Blog # 53

 

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have been working in Pediatric Oncology unit of a public hospital for several years. The mission of this blog is to bring to you the real-life stories of child patients suffering from cancer. Cancer is still a difficult disease to handle and treat. However, when it strikes the children, some so young that they cannot even speak, their agony is beyond expression and words. Let us pray especially for children suffering from cancer for early and complete remission. May Allah shower His Merciful Blessings upon them. Aameen.

 

In 2016 Abdullah was only two and half years old, when he started intermittent high-grade fever and body and joint pains. He was unable to stand mostly. Parents consulted doctor when his condition got worse. He was diagnosed with Acute lymphocytic leukemia at the age of 2.5 years.

The family is from Gujrat, father is small shop owner, and he has four children, two daughters and two sons. Abdullah is the younger son.

Initially Abdullah remained admitted and diagnosed in PIMS Islamabad but after final diagnosis he was referred to Children’s hospital Lahore. His treatment started in fall 2016 with chemotherapy cycles and completed after three years in 2019. It was a long duration for a family for multiple visits to another city leaving unattended three children and shop behind. No doubt a very tough time but the family invested their every effort for the sake of their son. Luckily after three years Abdullah defeated cancer and he was fine. It was a great news and they left for their hometown happily.

For two years Abdullah was healthy and growing happily, he was admitted to school as well. In fall 2021 exactly after two years of his recovery, Abdullah had fever and testicular swelling. Mother took him to hospital again, doctors said few tests will be done. His MRI brain and abdomen was also done. His surgery was planned but could not be done due to some administrative issues.

Abdullah got face swelling and stomatitis and is admitted again he is unable to even swallow anything. His mother once again mustered up courage and has brought him to hospital. She started crying while narrating the whole history. She is simple housewife who keeps on asking every doctor that whether her son will be alright.

This question is too difficult to reply, Abdullah’s tests are still being done and it is high probability that his cancer has relapsed. We have a plan to start his chemotherapy as per the relapse protocol, but it is too early to say anything and not an easy task to explain to his mother about her son’s cancer. She has only spent two years of relief after a long duration of treatment in another city.

Abdullah is too innocent and young to know what is going on with him. When I was standing near him, He was opening his Chips bag to give to another child as he himself was unable to eat due to stomatitis. Intensely emotional scenes are seen in daily routine in a pediatric cancer unit.

 

We pray for the ease of the Abdullah and his family and the complete health and recovery of Abdullah and all warriors who are suffering with their families.

May Allah ease and cure all patients and cancer warriors.

 

 

Note: Names have been changed to protect identity

 

Warriors and Survivors - 52

Children Cancer Stories by Rukh Yusuf - Blog # 52

 

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have been working in Pediatric Oncology unit of a public hospital for several years. The mission of this blog is to bring to you the real-life stories of child patients suffering from cancer. Cancer is still a difficult disease to handle and treat. However, when it strikes the children, some so young that they cannot even speak, their agony is beyond expression and words. Let us pray especially for children suffering from cancer for early and complete remission. May Allah shower His Merciful Blessings upon them. Aameen.

 

Whenever I meet a child patient, I remember him/her for days, patient’s condition remains in my mind for quite some time. I believe this is the same for many health care providers, we remain in stress, we keep praying in addition to taking care for our patients.

Shaban is twelve years old boy, looks very healthy and has a tall strong build. He belongs to a well-off family of Lahore. His father is a businessman and among his siblings Shaban is in middle, one elder and one younger brother and they have one younger sister.

Few months back Shaban was alright, one fine day when he was back from school, he had two episodes of vomiting. He was having pain in abdomen. He was fine after some time, but the same pain and vomiting episode recurred after couple of days. Parents took him to physician, and he gave regular medicines and Shaban was fine in some time. Unfortunately, he had same episodes again, abdominal pain and vomiting. This time on scan a mass was seen in his abdomen. He was admitted in Children’s hospital and his thorough workup was started.

After investigations, Non-Hodgkin’s Lymphoma was diagnosed, no doubt it was the worst news a family could ever have.

Non-Hodgkin lymphoma is a type of cancer that develops in the lymphatic system, a network of vessels and glands spread throughout body. In non-Hodgkin lymphoma, the affected lymphocytes start to multiply in an abnormal way and begin to collect in certain parts of the lymphatic system, such as the lymph nodes (glands).

The lymphatic system is part of immune system. Clear fluid called lymph flows through the lymphatic vessels and contains infection-fighting white blood cells known as lymphocyte. The affected lymphocytes lose their infection-fighting properties, making one more vulnerable to infection. The most common symptom of non-Hodgkin lymphoma is a painless swelling in a lymph node, usually in the neck, armpit, or groin.

Shaban’s treatment was started and just before starting chemotherapy, poor child got sick and multiple issues arose simultaneously. He was having multiple complications due to this. He was having continuous high blood pressure and developed fits later. His Cancer had spread already, and he was getting serious day by day. He was admitted in Oncology unit but was shifted to High dependency unit. Being NPO he was being given IV nutrition too.

His blood pressure was rising too; I met him in his unconscious condition. Whenever I visited him, His aunt was there. I came to know later that his mother is too grieved to see him in this condition. Mother got faint twice to see his grown-up child in such a poor condition, so she was kept away. What a heart wrenching situation.

It was Saturday afternoon when I last saw him and prayed for his miraculous recovery. I was having an eye on ICU update as well but could not find his name in ICU patients. I thought he has been shifted back to his room. But I heard the shocking news on Monday morning that he expired on Saturday night, …ahh. I am unable to imagine how his mother would have faced it. What a loss, no one could have thought that a young healthy-looking child would die so quickly in days. I still remember his painful condition.

We pray for the ease of the Shaban’s suffering family and the complete health and recovery of all warriors who are suffering with their families.

May Allah ease and cure all patients and cancer warriors.

 

 

Note: Names have been changed to protect identity

 

Warriors and Survivors - 51

 

Children Cancer Stories by Rukh Yusuf - Blog # 51

 "Ewing's Sarcoma"

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have been working in Pediatric Oncology unit of a public hospital for several years. The mission of this blog is to bring to you the real-life stories of child patients suffering from cancer. Cancer is still a difficult disease to handle and treat. However, when it strikes the children, some so young that they cannot even speak, their agony is beyond expression and words. Let us pray especially for children suffering from cancer for early and complete remission. May Allah shower His Merciful Blessings upon them. Aameen.

I met Ahmad Hassan a couple of days ago. He is twelve years old and is eldest among his siblings; eldest of five brothers and one sister. When I saw him he was talking to his father on phone while his maternal grandmother was sitting with him and she was quiet worried for his grandson. What a heart wrenching scene, parents must be away to look after and earn for their family and their eldest son is fighting a hard battle. Ahmad Hassan’s father is a laborer, mother is housewife, and she has to look after younger children as well. The brave family belongs to Bahawalnagar.

Ahmad Hassan was fine three months ago, suddenly he felt some swelling on right chest and back pain. The swelling enlarged with time. The parents contacted doctors, and they referred him to Children’s hospital after seeing his condition.

Thorough workup and investigations were done for Ahmad Hassan’s mass on chest along with the mass biopsy and He was diagnosed as case of Ewing’s Sarcoma. He was admitted in Children’s Hospital first time in January 2022 and now he is on his third chemo cycle.

Ewing sarcoma is a rare type of cancer that occurs in bones or in the soft tissue around the bones. Ewing sarcoma most often begins in the leg bones and in the pelvis, but it can occur in any bone. Less often, it starts in the soft tissues of the chest, abdomen, limbs, or other locations.

Exact cause is not known but most Ewing's sarcomas result from a chromosome rearrangement between chromosomes #11 and #22. This rearrangement changes the position and function of genes, causing a fusion of genes referred to as a fusion transcript. So, we may call it a result of genetic rearrangements.

He is Alhumdolillah improving but he is too weak for a 12-year-old guy. He looks too thin and dark; the reason may be poverty or its racial look, but I wish our children should look as healthy and happy as of developed world.

But the good thing is whatever the circumstances are, they keep on fighting even with fewer resources, low or no money. Sometimes they don’t have anyone to manage home and hospital and suffering child but then near blood relatives like Aunts or grandmothers come along to serve.

Ahmad Hassan’s family is also striving hard for their elder son facing every difficulty including frequent travelling from Bahawalnagar with less resources. Family and health care providers are striving hard for these children. May Allah protect and bless them health.

We can pray for the ease of the suffering family and the complete health and recovery of Ahmad Hassan and all warriors who are suffering silently and those who even don’t know their disease and what is going on with them.

May Allah ease and cure all patients and cancer warriors.

 

 

Note: Names have been changed to protect identity