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Showing posts from January, 2012

Starting chemo

On Sunday we took Asa back to London to begin chemotherapy.The first doses of drugs were given on Monday, and we returned home late the following day.During the stay in hospital we had an opportunity to reflect on the pros and cons of Asa's condition versus other kinds of cancers, and the treatment regimen he's on.
One thing was vividly impressed on us: Asa isn't the first or the last child to have cancer; his isn't the worst or the best case that's been seen; and the treatment regimen he's on isn't the most or the least radical that's been used.In short, we gained a sense of the ordinariness of what, a week ago, seemed like an exotic diagnosis.And the normality of a course of treatment that, after the doctors announced it a few days ago, seemed to make removal of his eyes look like an attractive option.
"Everyone here has a Hickman"
A Hickman line is a port used for delivering drugs directly into veins, and for taking blood out of them.It’s like…

Asa's status, and the way forward

Yesterday Selam, my mother, and I took Asa to London for assessment by retinoblastoma specialists.  In due course I’ll describe the health workers we met there.  Our first impressions are that they’re brilliant people who wear their knowledge and expertise lightly.  Based on the examinations they carried out and on what they told us, we’re now in a much better position to understand the stage of the disease and the treatment that’s necessary.

The stage of the disease

The International Classification for Intraocular Retinoblatoma grades severity on a scale from A to E.  A represents the best outcome, where chances of preserving vision are very good, and E represents the worst, where the eye must be removed to prevent metastasis. 

Asa is a D in both eyes.  There are multiple tumours in each eye, and they are large.  One indication of their size is that, while ocular tumours are conventionally described in millimeters, those in Asa’s eyes were described to us in centimeters: The largest in…

Asa's eyes

When Asa was 5 or 6 months old, Selam noticed something about his eyes.  Under certain light conditions, they would reflect light back, the way cat’s eyes do. 
“This child has animal’s eyes,” she said.
Neither Kuri nor I thought much of it.  It was amusing, we thought; a trick of the light; not a cause for alarm.
When I arrived in Ethiopia 3 days ago, Selam had just come across some information online that suggested this could be a sign of disease.  Whiteness at the back of the pupils is a characteristic of retinoblastoma, a cancer of the eye.  It’s rare, but more common in infants than adults.
Another sign of the disease is that in flash photographs with “red eye”, the eyes of affected children appear yellow or white rather than red. 
Going through old photos, Selam noted that this “yellow eye” phenomenon showed up for Asa in photos from 3 or 4 months ago.

Yesterday morning we took Asa to an ophthalmologist in Addis Ababa who examined his eyes and corroborated the possibility of retinoblas…