I don't immediately recall the exact date because, at the time, it didn't seem important that I should. I think it was the Wednesday or Thursday following Halloween, because in chatting Maggie up, the doctors, nurses, and lab techs all asked her about her costume. (A fairy princess.)
That evening, Maggie mentioned that she had pain behind her right ear. When we looked, we found that two or three lymph nodes were quite swollen. This wasn't too concerning; I have seen, and had, swollen lymph nodes due to viruses and allergies. But the number, combined with her discomfort and that only her right side was affected, gave us pause.
First thing the following morning, we made an appointment with our pediatrician. Dr. A examined Maggie, concentrating on the chain of lymph nodes running from behind Maggie's right ear down to her collarbone. Aside from this, it seemed no different than any other appointment that we'd ever had - until she called in another pediatrician who proceeded to give the same attention to Maggie's lymph nodes. This made me a little nervous.
Dr. A asked us to go to the hospital for some blood work and then return to the office that afternoon so that she could go over the results with us. I called Gus from the nurse's station and he made plans to meet us.
There were some abnormal white blood cells, Dr. A told us, but they were probably reactive - enlarged due to stimulation from a virus. I didn't really know what she was talking about, but I felt reassured. Gus, who is exponentially more savvy than I, heard what wasn't being said. He asked about the possibility of cancer. Dr. A said that Maggie wasn't showing any other symptoms, but she wanted to follow up with more blood work and an appointment on Monday morning. (Can I even begin to express how much we love Dr. A?)
Over the weekend, Maggie's nose started to run. We were so relieved to have a sick kid! It would seem that this was nothing but an ordinary virus. But then the runny nose disappeared and the swollen lymph nodes remained - and increased in number.
Over the next couple of weeks, each smear of Maggie's blood turned up roughly the same number of abnormal lymphocytes. Dr. A consulted Dr. V, a pediatric hematologist-oncologist, at Children's Hospital of the King's Daughters. Together, they decided that we should bring Maggie to the hospital for further testing on the morning of November 18.
This new round of blood testing showed the same lymphocytes and, a new development, anemia. The decision was made to aspirate some marrow from her hip. This was about noon. Gus and I were told that a diagnosis would come back in a couple of hours.
At four, Gus was studying in the clinic room that had been made available to us for the day, and Mags, Ellie and I were goofing around in the play area. Bryan, the child life specialist, approached with a nurse and offered to watch the girls while Gus and I met with the doctor. That we were to receive the results without the girls seemed ominous. By the time I made it back to the room, I was panicked. Gus clearly had the same sense of foreboding; why else would the test results take so long to return? I started to cry.
Dr. V finally entered, along with a social worker, a medical student, a nurse (soon to be Maggie's nurse), and extra chairs. (When they bring in the chairs, you know it's bad.) And that's when we found out that Maggie had ALL.