When you come to a fork in the road, do you take it?

Dear Madeline,

Well, sweet pea, the second run at the non-surgical approach to fixing your intestinal tract yielded no results despite valiant efforts. Consequently, you were made to endure another surgery. I give the surgeons a great deal of credit; they went in laparoscopically first and at least were able to get a camera shot of what they needed to address. What they found surprised them. Scar tissue from your first surgery caused your small and large intestines to fuse together, resulting in the large intestine "swallowing" about 1 ft. of your small intestine. We were all aware that this was a possible complication of the original surgery, but we also knew that the chances of it happening were remote. Baby girl, there is no need to go through life with a punch list of rare feats to accomplish. Rare childhood cancer and remote surgical complications should be enough!

Unfortunately, they were not able to resolve everything without reopening your original incision. Although the non-surgical approach relieved much of the problem, surgery was still needed in order to fully correct everything. The good news is that they did not need much time in the operating room to do the job, and that your intestines were still in good overall health such that more radical measures were not needed. It was a quick open-and-close. There are still some real concerns going forward, though.

While the surgery was both necessary and successful, it throws a fairly significant wrench in your treatment plan and presents a rather big question mark in terms of how the doctors will ultimately proceed with radiation treatments (which were supposed to be daily through the end of this work week). For now, everyone here agrees that there should be a break in the radiation treatment through the end of the week.  For everything you've been through, you're something of a unique case. What happens next is too big a question for the team at Hopkins to solve alone, so they are reaching out to their peers at other hospitals and the researchers at the Children's Oncology Group. It's fair to say that we're relieved to have you out of the surgical woods but are still quite concerned about what your future holds. No matter the case, we'll be with your through it all.

Love,

   Daddy