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Paper: Banner, The (Bonita Springs, FL) Title: Taking Nothing for Granted: When a Child is Diagnosed With Leukemia Date: June 19, 1996
By LIZ ERNST Staff Writer
On Thanksgiving Day 1993, Julia Constantine was battling a bronchial infection - not too unusual for an active 5-year-old. But after a few weeks of antibiotic therapy, Julia was getting no better. Her cough persisted, and her breathing remained labored enough to require her to have an inhaler nearby all the time.
Just four weeks after their daughter's symptoms first appeared, Mike and Nancy Constantine were stunned to learn their daughter had leukemia. Within a four-week period, the San Carlos Park family's lives changed forever.
“Just before we found out she had leukemia, we were worried about the braces our older daughter needed,” Mike said. “Our worries went from braces to this.”
Two and a half years later, Julia is in remission. At 7, she seems no different from any other little girl. Artistic, athletic, a bit shy at first; there are few signs of the radiation and chemotherapy Julia has weathered. Her silky brown hair - once diminished as a result of chemotherapy treatments - has grown back. If you were to meet Julia on the street, chances are you'd only notice her smoky gray eyes and limitless energy.
“She's a beautiful child. Otherwise she's a picture of health,” said Dr. Jerry Barbosa, Julia's pediatric oncologist. Leukemia has been identified in virtually every corner of the world.
In the U.S., about 70,000 people are being treated for the disease otherwise known as cancer of the blood and the blood-forming tissues. About 22,000 new cases are reported annually, and about 15,000 people die from it each year.
Leukemia is the culprit in half the cancer victims under the age of 15. The human T-cell leukemia that has invaded Julia's body is slightly more common in boys than girls for reasons no one knows. Although the exact cause of leukemia remains elusive, T-cell leukemia is known to be caused by two viruses - HTLV-I and HTLV-II, first identified in the 1970s. These viruses cause cancer by attacking the cells known as T lymphocytes (found in the tissue of lymph organs), causing the cells to multiply uncontrollably and invade various tissues.
Some of the symptoms can resemble any typical childhood malady: irregular fever, nagging cough, difficulty breathing - all symptoms Julia had. She also developed a tumor in her chest indicative of T-cell leukemia, but not common to all of its victims. “She had all the classic symptoms,” Nancy said.
Julia spent the first week after her diagnosis in All Children's Hospital in St. Petersburg.
She was released on Christmas Eve but returned Christmas Day with a fever. It was a result of the chemo, Nancy said.
While their daughter battled the illness, the Constantines adjusted to life in an environment few parents ever have to think about: a pediatric cancer ward.
“I asked the doctor if she was going to die,” Nancy said. “I just blurted it out. That was the stupidest thing I ever did.
“I mean, I blurted it out. It was the first thing that came to my mind,” she said, recalling her initial reaction within earshot of both her daughters.
“Immediately (Julia) asked me that, and her sister asked me that,” Nancy said.
Although the Constantines are careful not to dwell on their fears; when Julia asks questions, they answer her honestly.
“We've always been up front with her,” Nancy said.
Still reeling from the news, the Constantines quickly discovered that the hospital wasn't what they expected.
Kids rode Big Wheels in the hallways. Some rode their IV poles. There were no hospital-issue bed gowns with the embarrassing open backs. Kids wore their own pajamas, and during the day they got dressed in their own clothes. The idea is to make life as normal as possible.
Although life for the Constantines has been anything but normal since Julia's diagnosis, they have learned to deal with it by remaining positive.
“The good things go with the bad,” Mike said.
“I could tell you a whole list of bad things, but I'm not going to,” Nancy added. “We have to remain positive. It's all we can do. There is no other choice.”
Meredith, Julia's 10-year-old sister, has adjusted and made friends with the siblings of other cancer victims.
“Each day that we get through, the better we are,” Nancy said.
Julia finished her chemotherapy May 30. They estimate nine to 12 months before her immune system is healthy enough to efficiently battle germs and infection. It will take about a year to determine whether she will stay in remission. If her remission lasts five years, Julia will be considered cured.
In the meantime, the Constantines take nothing for granted.
“We take it day by day,” Nancy said. “Right now we have to deal with what we're faced with. I can't look at long-term.”
Barbosa said Julia seems to be heading toward a healthy future, although he makes no promises in his line of work.
“The longer a child remains in remission, the better her chances for survival,” Barbosa said. “Additionally, the prognosis is worse if the child relapses during the course of chemotherapy.
“We really expect her to do very well. Of course, we don't guarantee anything, but we've got a feeling that she's going to be a long-time survivor.”
Barbosa said a number of his patients have grown up, married and had children of their own.
“She should be able to grow up and be a member of society,” he said.
Three years ago, Mike and Nancy Constantine would have taken those words for
granted.
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