A/N: Hey guys, how have you been? Sorry it's been awhile since I've updated, I've been crazy busy! Anyways, here's the next chapter! Enjoy!
Disclaimer: I do not own Criminal Minds and/or its affiliates
*I am NOT a medical specialist or practitioner in any shape or form, the information and knowledge I have received is accredited to various medical online resources found through general google searches. The information I have included is as accurate as possible, though I am not to be consulted.
"Alright," Dr. Kershaw said as he settled into a chair at the foot of Isabel's bed the next morning,
"Let's talk about treatment."
JJ and Will eyed him, willing for him to go on,
"Basically, you can separate ALL treatment into three steps; induction, consolidation, and maintenance. Induction will last about four to six weeks, consolidation will be around one to two months, and maintenance, the longest step, will be two to three years, however, simply due to the fact that Isabel is over the age of ten years old, she is considered a high-risk patient, so, odds are maintenance will be closer to three years. We will begin induction as soon as possible; during this time, we will give Isabel inductive chemotherapy, which isn't too high-dosage, but it is very aggressive. Some of the medication we inject will have to go through the puncture we made during Isabel's spinal aspiration, in order to get the drugs to the central nervous system, which is key for preventing the spread of the cancer from her blood to her nerves. There are four medications that will be administered during induction; Daunorubicin, Vincristine, Prednisone, and L-Asparaginase."
"What do each of those do?" Will asked
"Daunorubicin slows and eventually stops the growth of cancer cells; Vincristine is a mitotic inhibitor, which means that it stops mitosis, a process that occurs in the metaphase of cell division. So, it essentially stops the division of cancer cells. Prednisone is a fairly common steroid that will ease inflammation. The main issue with Prednisone is that although it isn't very uncommon and is used for a wide variety of diseases and issues, it is an immunosurpressive drug, and it will make Isabel much more vulnerable to common sicknesses such as the common cold or the flu, as well as infections. We manage that with therapies that are administered later on, but for the next few weeks, we need to keep Isabel away from sick people as much as we possibly can. Finally, L-Asparaginase. Now, this drug is one of my personal favorites; essentially, your body produces amino acids, some are good, or essential, and some are bad, or non-essential. One of the non-essentials is called asparagine. Normal, healthy, cells can make their own asparagine, while cancer cells cannot. So, the L-Asparaginase cuts off the transition of asparagine into acid, leading to the death of leukemia cells. It is very effective, although it can cause an allergic reaction. Luckily, we start off with a very low dose of it, and the Prednisone will greatly reduce the severity of the allergic reaction, should Isabel suffer one. Any questions?"
JJ was able to follow all the information pretty well, but was unsure what was going through Will's mind.
"So, which medications will go through her spinal aspiration?" Will asked, his voice shaky.
"L-Asparaginase and Vincistrine will go through an IV in her arm, while the other two will go into her spinal chord." Dr. Kershaw was happy to see the look of confusion on Will's face fade; he knew it was a lot to take in and that confusion was a typical first reaction when learning about treatment.
"Will she need radiation?" JJ asked hesitantly. She knew radiation was painful and had nasty side affects.
"No, fortunately. Because Isabel is in a fairly early stage, she won't need it. We tend to avoid radiation as much as we can with children in general, because it hinders growth and development, and it is very painful."
JJ was relieved, and when she looked at Isabel she was happy to find that her daughter was as well. Isabel was clearly understanding the majority of the information that was being fed to them, and she even seemed intrigued and curious.
"Anything else you want to know?" Dr. Kershaw asked lightly, looking at each of them as he did.
"When do we start?" Isabel asked
Dr. Kershaw chuckled and smiled at her,
"This afternoon."
Xx
Isabel sat leaned forward, gripping JJ's hand tightly as the catheter was inserted into the small hole in her spine. When it was finally in all the way, a look of relief washed over her face, and she slowly leaned back once it was taped into place. JJ knew she wouldn't like the next part at all; the IV that was going to be inserted into Isabel's arm was dauntingly large, and Isabel had been eying it since she sat down.
"Don't look Princess." Will said as he settled in a chair next to her.
Isabel turned to JJ, closing her eyes and squeezing JJ's hand tightly, and squealed softly as the needle sunk into her vein.
"Okay sweetie, it's in." The nurse said, placing a gauze pad over the sight of insertion and taping the tube into place. She then connected the tubes to the bags that contained Isabel's medicine, and soon enough the life-saving chemicals were flowing into Isabel's system.
"Will I likeā¦feel anything?" Isabel asked shyly, looking up at the nurse.
"No, not for a few hours, and even then it won't be pain. You may feel dizzy, nauseous, tired, but you won't be in any pain." The nurse placed a pillow behind her back so as to relieve the pressure.
"Do you want or need anything else? Some water or juice, a magazine maybe?" The nurse asked, looking at all three of them.
"I'm fine, thank you." JJ responded
"No thank you." Isabel chirped
"No, thanks" Will replied, looking over at Isabel as he did.
"Alright, well feel free to let me or any of the other nurses know. Dr. Kershaw will come check on you shortly." The nurse nodded at them, and left.
JJ was fascinated by the flowing drugs that were being pumped through the tubes into Isabel. Each medication was a different color; the Daunorubicin a cherry red, Prednisone, light steely grey, the Vintricine a nearly-opaque white, and the L-Asparaginase completely clear. JJ thought about the amazing things this combination of drugs would do within her daughter's tiny system. Each medication had a role, but that role would only work to it's full capability when in specific combination with the other three chemicals. JJ found it incredible how powerful something so simple was, and how medicines like these saved lives, and all it took was a needle and a tube.
JJ knew there would be many more days like this, and that despite the good things these chemicals were doing, they came with harsh side effects. Isabel would lose weight, her hair would fall out, she would become more susceptible to sickness, and she would be very tired all the time. However, in this moment, JJ simply watched her little firecracker sit with a light expression on her face, her eyes full of life and spark, and JJ knew she would pull through.
At least, she hoped she would.
