Building Dreams Together: Rikki's story
This is the fourth in an ongoing series of stories about some of the children we are helping through Building Dreams Together: The MultiCare Campaign for Healthy Children.
Today, meet 12-year-old Rikki Garces, who is in good health after being admitted to MultiCare Mary Bridge Children's Hospital & Health Center for cancer treatment.
When young Rikki Garces was diagnosed with cancer, her family soon learned they had a “team of angels” on their side.
Rikki Garces is an energetic 12-year-old. A gifted student in her school’s Quest program, she plays the piano, the flute (in the school band), and is hoping to begin guitar lessons soon. Rikki reads at the twelfth-grade level, loves Richard Riordan’s Percy Jackson books and enjoys doing art projects.
In many ways she’s your typical bright young girl, except that last summer, Rikki’s life took a major detour. She was diagnosed with Stage 4 Hodgkin’s lymphoma.
A parent’s worst fear
As her mother, Luanne Garces, recalls, it was a Friday morning in July 2013 and the family was at the breakfast table when she first noticed the lump on Rikki’s neck.
Luanne, a Registered Nurse in the Adult Medical Surgical Unit at MultiCare Tacoma General Hospital, examined the lump and became concerned when she found that it was large, fixed and hard. Struggling to maintain her composure, she made an appointment for Rikki to see her pediatrician that day.
Because Rikki had had tuberculosis (TB) as a child, the pediatrician was concerned that the lump might be a recurrent TB infection, so she had Rikki admitted to MultiCare Mary Bridge Children’s Hospital, where she was kept in isolation.
Over the next several days, multiple TB specimen and blood tests were administered, followed by a needle biopsy. No active TB infection was detected, but the cells looked suspicious.
An open biopsy provided a larger tissue sample and a definitive diagnosis: Stage 4 Hodgkin’s lymphoma. While Rikki was still sedated, the surgeon inserted a port catheter, so she could begin chemotherapy without a second procedure.
Kid-friendly comfort and support
When Rikki awakened and discovered the port catheter, she was upset and confused, but was quickly comforted by a Child Life specialist, who explained that it was there to make chemotherapy easier on her body.
Soon after her surgery, Luanne, her husband and their son met with Rikki’s care team: Robert Irwin, MD, her medical oncologist; Candice Brandenburg, Oncology Clinic Coordinator; Julie Hertzog, her Child Life specialist; Tammy McKay, her pediatric psychiatric counselor; and Jessica Dingman, her social worker. Myrna Ruffy, her care manager, participated in later meetings.
The group shared the diagnosis, went over the treatment plan and urged the family to bring questions to them, rather than online. They also told Rikki’s parents not to worry about bills; their social worker would help them with the complications of dealing with billing and their insurance company.
“They told us to concentrate on Rikki and they would be there to help with everything else,” recalls Luanne.
Treatment for the whole child
Round one of inpatient chemotherapy lasted for a week because Rikki’s chemo drugs needed to be adjusted. For the second through fifth rounds, she spent two days in the hospital and completed the rest of each round on an outpatient basis, going half days to school and getting chemo in the afternoons.
Throughout treatment, Rikki was determined to continue in her school’s Quest program, a curriculum designed for gifted and high-achieving children.
To help Rikki succeed, another social worker, Anne Young, met with the school nurse and they created a 504 plan. The plan outlined special accommodations, such as allowing Rikki to have rest periods when she needed them and letting her complete class work while undergoing chemotherapy, which would enable Rikki to keep up with her class.
In addition, her Child Life specialist, Julie Hertzog, discussed Rikki’s illness with her class, clearing up any misconceptions the other children had and offering suggestions as to what the class could do to support her.
Thanks, in part, to Julie’s efforts, Rikki was able to attend school while undergoing her last three rounds of chemotherapy.
Life after cancer treatment
After chemotherapy was completed, Rikki began two weeks of radiation. Her final treatment was on Dec. 23, 2014, which, according to Luanne, was “a Christmas gift for the whole family.”
Today Rikki continues to do well. As her mother points out, she’s a strong, vigorous child who just happened to get cancer.
As happy as the Garces family is to have this experience behind them, Luanne is quick to sing the praises of Rikki’s care team, as well as family and friends from their church, school and community, who supported her daughter and her family with such grace.
“We are blessed that we met this incredible group of people," she says. "They are amazing. As a nurse, I was particularly impressed by the oncology nurses; they were so knowledgeable, so skilled and so kind to my daughter.”
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