Dagboek van Philippa/ Philippa's diary
Email: philippa@rdenhollander.nl                                   Last update: 14-06-04 21:29.







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As you have probably heard Philippa had a lymphoblastic lymphoma removed from her arm a few weeks ago and sadly the biopsy revealed that the cells in the lymphoma were malignant. As you can imagine we were devastated when we were told this news. Our lives changed overnight as we prepared to start the chemotherapy. Although Philippa does not have leukaemia she is to have the standard risk chemotherapy for the illness as a preventative measure. In the past patients were not treated after the removal of tumours and statistics showed that tumours appeared in other places and could also reappear as leukaemia. The treatment takes two years and has three phases; we are currently two weeks into the first phase – the induction treatment. This is 6 weeks of intensive chemo. The second phase is 5 weeks and involves the cleaning of the central nervous system. The third and last phase is the maintenance treatment and is 100 weeks long. Each phase follows on from the last with no break in between and is only differentiated by the change in drugs. Only one day after hearing that the bone marrow and central nervous system were clean of cancer cells, we were in the Academic Medical Center in Amsterdam starting the treatment. I say “we” because although Philippa is the only one taking the medication, cancer affects everybody close to the patient. We have been with her day and night, in and out of hospital. The first week of treatment was tough; Philippa had a severe reaction to the Vincristine injection she had received and suffered intense pain in her jaw and stomach. There was even talk of her having mumps because of her reaction to the medication and as a preventative measure we were moved to an isolated room. She takes three tablets a day of Dexamethason, a laxative and an ant-emetic to counteract the side effects of the Vincristine, paracetamol in large doses and the Vincristine injection once a week. At the end of the first week in hospital she had the second injection and we were allowed to go home. This was another hard week; I have to record every drop that she drinks because too little fluid intake could mean permanent kidney damage. For the first five days she did nothing but drink and refused point blank to eat. She lost 1.5 kilos in three days and by the time we saw the oncologist there was already talk of feeding her via a drip through her nose. This is unusual because normally children on Dexamethason eat like horses and this was yet a further indication that Philippa was not reacting well to the Vincristine. Since we had seen an improvement in her general health a few days after the Vincristine injection we expected the same in the second week – it didn’t happen. On the Wednesday she was just as lousy as before and last Thursday she was due for the third injection. She was generally subdued after the injection but that is normal for a child who is by now justifiably afraid of needles. She slept well and was not unusually poorly in the morning.