The fight to save Bre­anna

Play ac­ci­dent re­veals tu­mour

Herald Sun - Motoring - - Good Friday Appeal - BRIGID O’CON­NELL

BRE­ANNA Thomas’s par­ents can­not stop their minds churn­ing through the se­quence of

Slid­ing Doors mo­ments from the past six weeks that has led them to be be­side their daugh­ter’s hos­pi­tal bed.

What if the storm that car­ried the tram­po­line across their pad­dock and into the neigh­bours’ yard hap­pened a week ear­lier, so the kids couldn’t play on it that Wed­nes­day af­ter­noon?

What if the three youngest of the six chil­dren hadn’t all wanted to jump at once, with their ex­u­ber­ant play forc­ing the two girls to col­lide?

What if mum Carolyn hadn’t per­sisted with mul­ti­ple doc­tor vis­its when her three­year-old com­plained of stom­ach pains?

Mrs Thomas knew as soon as she saw the mass ap­pear as the ul­tra­sound wand glided across Bre­anna’s bloated ab­domen six weeks ago at the Royal Chil­dren’s Hos­pi­tal that this was se­ri­ous.

With hus­band Ste­wart by her side, she had ex­pe­ri­enced her fair share of ul­tra­sounds her­self while preg­nant. This time she was on her own.

“I think I shocked him (the doc­tor). Straight away I just went, ‘What is that?’,” she said.

“He was very thor­ough. I watched him mea­sure it. I could see it was 15 by 13cm big. He said it was a tu­mour. My heart just stopped.”

RCH doc­tors be­lieve that the fast-grow­ing Wilms’ tu­mour — the size of a small soft-toy foot­ball — had been grow­ing for three or four months.

It was sim­ple to ex­plain to Bre­anna why she was in hos­pi­tal. She could un­der­stand that there was a “yucky in her tummy” that doc­tors needed to take out for her to feel bet­ter.

It was a harder con­ver­sa­tion to have with the older chil­dren — aged 11, 14 and 15 — who re­mem­ber their par­ents’ an­guish at los­ing a daugh­ter eight years ago, still­born at full term.

“The big­ger kids al­ready know what it’s like to lose a sib­ling, so their first ques­tion was ‘is she go­ing to get to the other end of it?’,” Mrs Thomas said.

“Most fam­i­lies wouldn’t face that ques­tion once, let alone twice.”

But Mrs Thomas had done her homework and could tell her chil­dren that a Wilms’ tu­mour orig­i­nated from the kid­neys and could be suc­cess­fully treated in more than 90 per cent of cases.

Be­fore it could be sur­gi­cally re­moved, Bre­anna needed four weeks of chemo­ther­apy aimed at shrink­ing the tu­mour.

HER straw­berry blonde hair had just stopped fall­ing out when she was booked for the surgery last Tues­day.

She ar­rives for the af­ter­noon list, groggy from the hour drive from her Mer­rimu home. One arm is tightly wrapped around her fa­ther’s neck and the other around her pink Min­nie Mouse doll.

Her nails are also painted pink, a prize she scored in the Chil­dren’s Can­cer Cen­tre lucky dip that all kids can dive their hand into af­ter un­com­fort­able pro­ce­dures, like blood tests or dress­ing changes.

Carolyn stays close to the surgery wait­ing room, but Ste­wart has an hour drive ahead to make the day­care and school af­ter­noon pick-up, and pre­par­ing din­ner for the other five chil­dren — one with gas­tro, an­other with a bro­ken hand — be­fore a friend ar­rives to babysit so he can re­turn to his daugh­ter’s side.

Pae­di­atric sur­geon Michael Nightin­gale said Bre­anna’s case was typ­i­cal in that the tu­mour was usu­ally found in­ci­den­tally as a lump in the ab­domen, and had com­monly grown quite large by the time it was dis­cov­ered.

It is a surgery per­formed on about eight chil­dren each year.

Re­cently the team has had suc­cess in per­form­ing it as a key­hole ac­cess, and also pre­serv­ing some of the af­fected kid­ney.

But Bre­anna’s tu­mour is so large will re­quire an in­ci­sion across the en­tire width of her ab­domen, and none of her left kid­ney can be saved.

The im­pact of the col­li­sion on the tram­po­line most likely caused the tu­mour to bleed.

And, while chemo­ther­apy shrinks tu­mours, mak­ing them safer and eas­ier to sur­gi­cally re­move, it has no im­pact on the 15cm-long blood clot, which was en­closed in the tis­sue sheath around the kid­ney.

Mr Nightin­gale likened his op­er­at­ing theatre task to get­ting a bal­loon out of a small hole. Bre­anna’s tu­mour is soft from the bleed, and rup­tur­ing it means au­to­matic ra­di­a­tion treat­ment to en­sure any spillage won’t lead to more tu­mours.

Af­ter ex­pos­ing Bre­anna’s ab­dom­i­nal cav­ity, her bowel must be repo­si­tioned to re­veal the kid­ney.

He then ties off and stitches the blood ves­sel be­tween the heart and the kid­ney. From there it is a slow, painstak­ing four-hour se­ries of mea­sured cuts, fol­lowed by more check­ing to see if the tu­mour has been prised from the ab­domen.

A board meet­ing was held this week to dis­cuss the next stage of Bre­anna’s treat­ment.

Mr Nightin­gale pre­sented the find­ings from the op­er­a­tion, the pathol­o­gists gave in­sight from what clues the tu­mour held, on­col­o­gists, nurses and ra­di­a­tion on­col­o­gists also pre­sented their rec­om­men­da­tions.

“We got it all out in­tact and no tu­mour was left that we could find,” he said.

“She will have more chemo­ther­apy and maybe ra­di­a­tion, and she will need fol­low-up for some time to check there is no sign of the tu­mour com­ing back and to mon­i­tor the health of her sole kid­ney. There is no rea­son if you look af­ter your health you can’t live a nor­mal life with one kid­ney.”

BRE­ANNA’S fam­ily are close-knit and the kids work on a buddy sys­tem. The el­dest of the three older kids is the buddy of the old­est of the three younger kids, and then down the chain it works.

If you make your bed, you also make your buddy’s bed. When you fold your clothes, you sort those of your buddy, too. If one of the smaller chil­dren is miss­ing from their bed in the morn­ing, it is guar­an­teed they will be in the dou­ble bed of their big­ger buddy.

Bre­anna’s buddy, 14-yearold Cal­lum, vis­ited his sis­ter af­ter the surgery last week. He had loaded his phone with

Dora the Ex­plorer, so she could watch with­out leav­ing bed. “All the kids have been so good and the hos­pi­tal has been amaz­ing,” Mrs Thomas said.

“We’ve just told the kids that when we’re through this, we’ll just take out a loan and just bug­ger off to­gether for a month on a fam­ily hol­i­day. We’re go­ing to take time away and re­lax, have a bit of fun.

“Our fo­cus at the mo­ment is get­ting her to the other end.”

She has been poked and prod­ded too many times, and clings to dad Ste­wart’s neck as she is car­ried to­wards the op­er­at­ing theatre.

Bre­anna is con­soled by her par­ents as she

waits for surgery. Pic­tures: ALEX COPPEL

Sur­geon Michael Nightin­gale marks the line for in­ci­sion to re­move the 15cm-long kid­ney tu­mour.

Scans show the tu­mour that had been grow­ing for about three months in Bre­anna’s tiny pelvis.

Bre­anna re­cov­ers in hos­pi­tal with the sup­port of her five sib­lings (main); pass­ing the time with Mum tak­ing self­ies dur­ing chemo­ther­apy (be­low).

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