Chesterfield | Services: Hematology/Oncology
Appreciating the Little Things
Venus Bolton describes her 6-year-old daughter Mireya as "the dainty one" of her four children so when Mireya began getting unexplained bruises, including on her neck and in her mouth, two years ago, Venus and her husband became concerned. Following initial blood tests by her pediatrician, Mireya was immediately referred to Children's Hospital of Richmond at VCU's (CHoR) Hematology and Oncology Clinic and admitted to the inpatient unit.
"We went to Children's Hospital of Richmond at VCU not knowing what was going on," recalled Venus. "Her platelet count was very low but her other blood counts were good so we didn't know what we were dealing with."
Mireya was eventually diagnosed with severe aplastic anemia, a disease where the bone marrow stops making red and white blood cells and platelets. Patients with severe aplastic anemia are at risk for serious infections and bleeding because red blood cells are important for carrying oxygen throughout the body, white blood cells for fighting infection and platelets for clotting blood.
Mireya spent 10 days in the hospital then returned to CHoR with a fever and increased bruising. While being evaluated for a bone marrow transplant, one of the treatments for severe aplastic anemia, Mireya developed appendicitis and had surgery to remove her appendix. She also received multiple blood and platelet transfusions during her one-month stay.
"Mireya's family was very inquisitive and involved in her treatment," said Kamar Godder, MD, MPH, Professor and Chief, Division of Hematology and Oncology. "We always encouraged the family to call with questions. We even used Facetime [iPhone’s video conferencing technology] when Mireya's dad was home with her siblings."
After evaluating Mireya's parents and siblings as possible bone marrow donors, it became clear that Mireya's brother, then 6-year-old Jalen, was a perfect match. Mireya was admitted to the Bone Marrow Transplant Unit and began a series of tests and medications including chemotherapy to prepare her body for the transplant. On July 6, 2011, Mireya received a bone marrow transplant, a date her nurses called her "new birthday" and recognized with cupcakes and birthday songs.
CHoR's Hematology and Oncology Clinic treated more than 2,000 patients last year. The Clinic's seven physicians, four nurse practitioners, physician assistant, and dedicated nursing and support staff, which includes a psychologist, chaplain, child life specialist, educational liaison, transition coordinator and two social workers, treat children with sickle cell disease, bleeding and clotting disorders, cancer and other bone marrow diseases. CHoR has the only pediatric bone marrow transplant program in Virginia and provides comprehensive patient care through collaborations with a variety of CHoR specialists such as infectious disease experts, gastroenterologists, neurologists, nephrologists and surgeons.
"Eighty percent of children diagnosed with cancer today survive into adulthood," said Dr. Godder, whose team diagnoses 50-60 new patients a year. "Although aplastic anemia is not a cancer, it is treated very similar to one and should be monitored and followed as such. We provide care from the initial diagnosis through the treatment phase and well into the after-treatment phase."
Mireya responded well to her transplant until March 2012 when her bruising returned, and tests showed her blood counts were dropping again. Doctors suggested another transplant, but this time through stem cells from blood rather than bone marrow. In August 2012, Mireya received her second transplant using blood stem cells from Jalen and recovered quickly. She started kindergarten with home-bound instruction last fall, and by March 2013 began full days at her local elementary school.
"A totally different child has emerged," said Venus of the changes in Mireya since starting school and having most other restrictions like taking baths and eating strawberries lifted. "The little things we haven’t been able to do, we can now do."
Mireya, who loves princesses, drawing and dolls, will continue monthly clinic visits through the summer and is looking forward to having another restriction lifted in August: getting into a swimming pool.
"When you live through isolation and restrictions, you have a new appreciation for things," Venus said. "Children's Hospital of Richmond at VCU has been so amazing to us. They have become like family."