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A Change of Plans
March 29, 2018
A Change of Plans

“Obadiah’s surgery was scheduled for September,” Kyle Tower recalled of his son’s second hernia surgery, “but because I’m a teacher, I wanted to do it in the summer. Fortunately Dr. Herndon had a cancellation, and Ob’s surgery was scheduled for July 3.”

Because the surgery was supposed to be routine, and July 3 was Kyle’s wife’s birthday, she stayed home with the couple’s almost 4-year-old daughter, Aurora, while Kyle took 18-month-old Obadiah to Children’s Hospital of Richmond at VCU’s (CHoR) Children’s Pavilion for the procedure.

During the pre-operation exam, Kyle mentioned to Obadiah’s doctor, C.D. Anthony Herndon, MD, FAAP, FACS, Professor of Surgery/Urology, Division Chief Pediatric Urology and Co-Surgeon-in-Chief, CHoR, that Obadiah had a hard area on his abdomen, a reduced appetite and traces of blood in his urine.

Wanting to check on Obadiah’s symptoms, Dr. Herndon immediately sent him for an ultrasound.

“Here at CHoR we are fortunate to have radiology down the hall from surgery,” said Dr. Herndon of his ability to quickly collaborate with his radiology colleagues while remaining near his surgery patients in the Pavilion. “During the ultrasound it became obvious there was something on Obadiah’s kidney.”

An Unexpected Twist

Doctors suspected that “something” was a Wilms’ tumor, a rare type of kidney cancer but the most common type of kidney cancer in children. Kyle recalled how Dr. Herndon sketched a picture of Obadiah’s body to show a fast-growing tumor the size of a softball on his right kidney. He postponed Obadiah’s hernia surgery and admitted the toddler to CHoR’s pediatric unit.

“I had to call Ashton and tell her she needed to come to the hospital to make decisions about Obadiah,” Kyle said of calling his wife about the change in the day’s plans. “When she got here, we both started crying and embraced each other. We were asking ‘what does this mean?’ but neither of us knew.”

Over the next two days, the Towers met with Dr. Herndon and Marieka Helou, MD, MPH, Assistant Professor, Hematology and Oncology, to discuss Obadiah’s case. They decided Obadiah would have surgery to remove the tumor and one kidney and have a port inserted for chemotherapy in case the tumor was confirmed to be cancerous.

Obadiah with doctor and mom for patient visit

On July 6, David A. Lanning, MD, PhD, Associate Professor of Surgery and Pediatrics and Co-Surgeon-in-Chief, CHoR, began Obadiah’s multi-hour procedure that included installation of his port followed by the removal of his right kidney and a one-pound tumor by Dr. Herndon. Kyle and Ashton received updates from the operating room every 15-30 minutes and were thrilled to learn the tumor was removed without any burst or spillage of the potentially cancerous cells.

Next Steps

For a few days after surgery, Obadiah was tired and cranky, but on July 10, Kyle’s birthday, Obadiah’s playful, happy personality returned, and on July 12, he went home. Less than two weeks later, after the tumor was confirmed to be cancerous, he returned to CHoR to begin weekly, outpatient chemotherapy treatments. Although Obadiah had minimal side effects from chemotherapy, he did experience hair loss, jaw pain and neuropathy, or numbness in his legs and feet, which resulted in him temporarily losing the ability to walk.

“He seemed very scared when he temporarily lost his ability to walk due to the neuropathy,” Kyle wrote on the family’s blog in July. “I can only imagine the confusion he has when his feet and hands go numb and his jaw is hurting.”

Throughout his treatment, because of the risk of infection, Obadiah had to limit his exposure to indoor, public places and people outside of his immediate family. For Kyle and Ashton, who love to entertain family and friends at their Richmond home, this restriction was challenging. Fortunately the family found many outdoor activities to enjoy together including playing in their yard and visiting local parks, a pumpkin patch and an apple orchard.

By September, Obadiah’s chemotherapy transitioned to every three weeks, and in November he completed his final treatment. During his four-month treatment, Obadiah also went to CHoR’s emergency room twice for high fevers, which were caused by RSV in August and a virus in October.

Looking Back, Moving Forward

“When the news first fell on our ears that our son had cancer, we felt a deep ache in our hearts that is indescribable,” Kyle wrote in October about Obadiah’s initial diagnosis. “The saying is true that you don’t know what you have until there is the possibility of losing it. All I could think about is how I adore his little laugh and how he gives the best hugs.”

One month after finishing chemotherapy and a couple weeks after his second birthday, Obadiah’s port was removed, and he finally had the hernia surgery that had been scheduled for the previous summer. He will continue to be followed by specialists from urology and hematology and oncology and will return to CHoR every three months to test his kidney function and check for new tumors.

“Being able to see multiple specialists during the same visit is helpful for Obadiah, his family and his doctors,” said Dr. Herndon, who is the first to hold the Children’s Hospital Foundation Endowed Chair in Pediatric Urology. “Other than restricting contact sports and use of ibuprofen, Obadiah’s prognosis is excellent.”

While Obadiah won’t remember his early experiences at CHoR when he’s older, he doesn’t seem to mind returning for check ups. The smiling, blue-eyed toddler adores his big sister and likes playing with cars, trucks and anything that spins. When he says, “I’m gonna get you,” his family knows it’s time for his favorite game, hide and seek. And while having pictures taken for this story, he enjoyed multiple snack breaks with one of his mom’s homemade muffins.

Obadiah and girl playing with toys in waiting room

Earlier this year, Kyle posted the latest update about “the sweetest Christmas gift for us this year. Obadiah’s CT scans have come back CLEAR meaning that our little man is considered in REMISSION from the cancer and will be moved to the survivor clinic!!! When we got the news we could barely believe what we were hearing and tears of pure joy filled our eyes.”

Looking back on the last seven months, Kyle said, “Every experience here has been wonderful. From the receptionists to the nurses and doctors, everyone cared about Obadiah.”

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