'I went to the GP because I had a pain in my side... a test showed I had leukaemia' - former school teacher
When Agnes Whelan heard she had leukaemia, her main hope was to see her young family grow into adulthood. She tells our reporter how, thanks to modern medicine, she has seen her precious children mature and prosper
Agnes Whelan has spent most of her life teaching children how to read and write. But an equally important part of her job is helping them develop skills that will allow them to cope with the hurdles they will inevitably face in the wider world.
However, a time did come when Agnes herself was forced into the role of unknowing pupil. But typically, this gutsy, determined Wexford teacher rose to the challenges, and she is now thriving.
Agnes grew up in Campile, near New Ross. Having achieved a BEd, she began teaching at the "lovely, well-run" Mercy School in Wexford town, where she remained until retirement.
In 1988, Agnes married local farmer Nick Whelan. They live in Kellystown, not far from Enniscorthy, and have three adult children. Currently, they grow wheat and barley; in the past, cattle and sheep munched the plentiful, verdant grass.
Nick and Agnes were content, knowing their lives were on course. But then fate threw the proverbial spanner in the works. During the summer of 2003, Agnes began to feel unwell. "I had a pain in my side and I wasn't sleeping," she explains. "So I went to my GP."
The doctor, noticing her spleen was enlarged, referred her to a local consultant who scheduled a battery of tests. It began one fateful day with a blood sample at 7.30am, which was sent to University Hospital Waterford (UHW) for analysis. In the meantime, other tests and scans were done. At that point, Agnes was more preoccupied with thoughts about what she would teach her class the next day, rather than what was going on around her.
But just 12 hours after that first blood test, her world was shattered when she learned she was suffering from chronic myeloid leukaemia (CML). "I could hardly remember what the consultant told me," she says, "I was literally stunned. The diagnosis was overwhelming."
Agnes says that the doctors, fearing she was in danger of suffering organ failure, told her to go to UHW straight away. And even though she and Nick only arrived at 11pm that night, chemotherapy began immediately. "It was hoped it would bring down that high white-blood-cell count," she says. And so she began to walk a completely different road to the one she had set out on just that morning.
Agnes soon learned that leukaemia is a form of cancer that affects bone marrow, which is a spongy material found inside bones. Bone marrow produces stem cells, and these play a pivotal role in the production of red blood cells (to carry oxygen around the body), white blood cells (to fight infection), and platelets (to stop bleeding). When CML is present, it causes stem cells to produce inordinate numbers of abnormal white blood cells, leaving the patient unable to fight infection.
The next day, Agnes had a bone-marrow biopsy. "It was very painful," she says, "but it did give doctors a full profile of my condition." Meanwhile, the ever-supportive Nick had to break the news to the children - who were then 13, 11 and eight years old - that their mother had leukaemia. "I felt the most important thing was to bring them to the hospital so they could see for themselves I was OK," Agnes says.
A great consolation for her was learning that her specific leukaemia wasn't the most aggressive form, and generally responded well to treatment. However, she also cautions against unbridled optimism."There is no cure for CML, except a bone-marrow transplant and possibly some very new drugs," she says. "It's fairly rare, with 30 to 40 cases diagnosed in Ireland each year."
Once Agnes's white-blood-cell count had decreased, she was able to go home. But she had to attend the oncology unit at UHW every couple of days, for chemotherapy and for close monitoring.
She was then referred to Dr Eibhlin Conneally, a consultant haematologist in St James's Hospital in Dublin. The possibility of a bone-marrow transplant was under review. One of Agnes's brothers had already been deemed a good match. However, she was also warned of the dangers inherent in a transplant, which included stem-cell failure, organ damage, and infections.
Following a case conference with her colleagues, Dr Conneally advised Agnes to try a drug that was fairly new in 2003; a drug that was showing good results. In the end, Agnes chose oral treatment instead of a major medical procedure.
"It saved my life," Agnes says. "But it did have unpleasant side effects, including stomach problems, rashes, headaches and severe fatigue." One of the reasons she struggled was because she needed to take the highest permissible dose.
Three months after her diagnosis, she returned to the classroom. However, because of the chronic fatigue caused by the drug and CML, she had to pace herself. "Teaching allowed me breaks to recharge my batteries. But I couldn't do anything else," she explains. "I had to keep life simple, so I could devote whatever energy I had to the children. They were fantastic, as was Nick, doing what they could to help me. Otherwise, I just got on with it. Some people even forgot I was sick, which suited me, as it helped me forget about it too."
In 2009, Agnes changed to a new medication for CML which had been developed since her diagnosis. "I'm still on that drug now, and have very few side effects," she says.
Because the changeover to the new drug necessitated her taking time off work, she decided to retire altogether. Since giving up work, she has resumed regular physical exercise, including golf, which she loves, even though she claims she "plays badly".
Agnes is now determined to spread the word that cancer can be beaten. "When you get a cancer diagnosis, it's not the life sentence it used to be," she says. "Years ago, they used to pump you full of chemo; now, it's much more specific. Dr Conneally looked at me as an individual with certain characteristics, and she took those into account when recommending my treatment," Agnes says. "I owe everything to her."
Currently, Agnes attends the haematology department at St James's Hospital every three months, where she is being monitored. "They're delighted with me," she says. Fourteen years after Agnes's initial CML diagnosis, she is a glowing example of what modern medicine can achieve, given the right set of circumstances.
"When I began my treatment, all I needed was time. My children were so young. I wanted to see them, if possible, through secondary school, exams, graduations, significant birthdays. I've been so lucky to have had all that, and so, so much more."
For more information, contact the Irish Cancer Society, tel: (01) 231-0500, or see cancer.ie
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