A Long and Winding Road
It’s hard to believe in September she was in a body cast,” said John Matthews of his two-year-old daughter, Rowan, as she ran around their Chesterfield County home this winter. While John and his wife, Brittney, relayed stories of a year filled with multiple medical tests, long hospital stays and extended courses of medications, Rowan happily danced, pushed her Minnie Mouse vacuum cleaner – and had a few short-lived, toddler meltdowns.
“Now we have a baby who cries 90 percent less than she did a year ago,” said Brittney of the journey that began last winter.
Last February, Rowan, the youngest of three children, became abnormally fussy until she was almost impossible to console. Then on Feb. 20, Rowan woke from a nap crying hysterically and unable to walk. Her parents took her to a local emergency room, and Rowan spent five days in the hospital where doctors suspected she had a virus affecting her bones. She also began experiencing random and rapid eye movements and was referred to an ear nose and throat specialist. By mid-March, when she was still cranky, hadn’t resumed walking and developed head tremors, her doctors sent her to the emergency room at Children’s Hospital of Richmond at VCU (CHoR).
An Uncertain Spring
“Nobody had mentioned anything life threatening at this point,” said Brittney who was shocked when CHoR doctors suggested neuroblastoma, one of the most common forms of childhood cancer, may be responsible for Rowan’s symptoms.
For the next 10 days, the Matthews stayed at CHoR while Rowan underwent multiple procedures and saw specialists from neurology, oncology and orthopaedics. Although tests could not confirm cancer, doctors still believed her symptoms could be related to the disease– or could be caused by a virus. Rowan returned to the hospital every four to six weeks for CT scans, and although her behavior had improved, by the end of May she still hadn’t started walking again.
“We felt like we were living an episode of ‘House,’” Brittney said of the popular television medical drama. “We still weren’t 100 percent sure if she had cancer. Her doctors were saying it didn’t look like it, but there was still something there, and we didn’t know what it was.”
A follow-up CT scan in June determined the toddler had a dislocated hip, an infection on her bone and areas of calcification on her spine. Rowan spent most of the summer in a spica body cast while her parents worried that her recent diagnoses could be related to cancer. At the same time, her case was referred to CHoR’s Tumor Board, a multi-disciplinary team of specialists that meets to review rare cases like Rowan’s.
A Meeting of the Minds
David A. Lanning, MD, PhD, Professor, Surgery and Pediatrics, Co-Surgeon-in-Chief, CHoR, attended that meeting and suggested a minimally-invasive procedure to remove the areas of concern on her spine.
“A lot of people come together for these meetings to review complex cases and create good solutions for the child,” said Dr. Lanning. “You have to be a specialized children’s hospital to have specialists that provide these out-of-the-box solutions.”
For John and Brittney, making the decision for Rowan to have surgery was not difficult.
“Her case was so rare,” Brittney said. “Nobody knew what it was, and we had seen almost every specialist. We needed to cross [every possibility] off the list.”
Because the surgery, which involved inserting a small camera and temporarily deflating Rowan’s lung to reach and resect the calcified areas, required only three small incisions, Rowan had a quick recovery and went home the next day.
On Oct. 17, nearly eight months after their journey began, the Matthews learned the mass removed during Rowan’s surgery was neuroblastoma. Additional tests revealed the cancerous cells had not spread, and Rowan didn’t require radiation or chemotherapy. She continues to visit specialists at CHoR for regular tests to ensure her cancer doesn’t return, but John, Brittney and Rowan’s doctors remain optimistic.
“We went eight months without any answers,” John said. “Surgery gave us an answer. If it weren’t for Children’s Hospital, I don’t know where we’d be.”