Brave 10-year-old is Herald Angel

Editor's note: This is the first in a series of articles profiling this year's Herald Angel.

by: Lance Martin - Herald Staff Writer

Alani Byrum is a typical 10-year-old in many ways. Like most children today, she likes to watch SpongeBob SquarePants on TV, loves playing with her baby dolls and plays normal. She enjoys school and is eager to learn new things.

However, Alani's first 10 years have been very different from the norm. Unlike most children her age, Alani is familiar with complex medical terms such as atrial septal defect, ventricular septal defect and coarctation of the aorta. Alani was born with a congenital heart defect.

The heart has four chambers and a wall called the septum separates the left and right sides. The septum prevents blood without oxygen from mixing with blood that contains oxygen. Within the heart are a series of valves that connect to major blood vessels and separate the two sides.

In a normal heart, blood flows from the body into the right upper chamber after the body has used it. This blood contains very little oxygen. This oxygen-poor blood then flows to the lower right chamber of the heart through a valve. From here, this blood is pumped into a blood vessel, the pulmonary artery, into the lungs where it is enriched with oxygen. From the lungs, this oxygen enriched blood flows through blood vessel the pulmonary veins, into the heart's upper left chamber. The blood then goes through a valve into the lower left chamber and is pumped through a major blood vessel, the aorta, and carries oxygen-rich blood to all parts of the body.

Alani's heart defects disrupted the completely normal cycle of her heart. Atrial septum defect, or ASD, is a hole in the wall that separates the upper two chambers of the heart. Alani's heart had a form of ASD that also causes the valve in her heart chamber to leak. This allows blood from the two sides, oxygen-rich and oxygen-poor, to mix and therefore, too much blood flows back to the lungs.

Alani also had coarctation of the aorta, which constricts a part of the main vessel that allows blood to flow back to the body. This defect can cause the heart to enlarge and usually occurs along with other defects. Alani also had a condition called ventricular septal defect in which there is a hole between the two lower chambers of the heart and the result is similar to what happens with the ASD.

Alani's heart defects were corrected with two open-heart surgeries, one at 16 months and another when she was six years old. During the last open-heart surgery, however, Alani suffered a stroke that today still causes some short-term memory loss and caused her to lose partial use of her left arm. Her mother, Melanie Byrum says this made it difficult for Alani to learn as easily as other children did.

Despite it all, Alani had started living a relatively normal life until she awoke on the morning of Sept. 23 with extensive pain in her stomach and a high fever.

"With all her heart problems, I always worry," Melanie said of that morning. Throughout the day, the pain in Alani's stomach increased and Melanie says she took her daughter to see Dr. Bhagwandass who felt a mass in her stomach.

Alani had complained off and on with stomach pain and Melanie had actually taken her daughter to see Dr. Bhagwandass earlier. Melanie says, "It wasn't anything that made you think you should rush her to the doctor because it was nothing that made her cry and it appeared to be just a normal stomachache like all kids get."

This day, however, was different and upon examination, Dr. Bhagwandass felt a mass in Alani's left side. Dr. Bhagwandass called a surgeon, Dr. Rao and asked him to meet them at the emergency room.

Originally, the thought was that Alani had appendicitis and Dr. Rao ordered a series of tests and a CT scan, which revealed the mass on Alani's ovary the size of a small grapefruit. Dr. Rao performed surgery and removed the mass, which was sent for analysis. Analysis later revealed Alani suffered with a form of ovarian cancer that occurs primarily in adolescents and young adults. The cancer, dysgerminoma, is very uncommon in children younger than 15.

This cancer originates in the germ (egg) cells of the ovaries and most often affect just one ovary. This type of cancer can be difficult to diagnose early and often there are no symptoms until a mass has grown extensively.

The cure rate for dysgerminoma is about 95 percent under normal conditions and treatment varies depending on the stage the cancer is in at the time of detection.

In Alani's case, doctors removed the mass and a part of her fallopian tube. She was then referred to an oncologist at Pitt Memorial Hospital in Greenville where a treatment plan was scheduled.

Doctor's at Pitt recommended a regimen of four to six months of chemotherapy.

Alani's life once again turned to medical terms, doctor and hospital visits and moved away from a normal childhood.

"I was so angry," Melanie says about Alani's diagnosis. "I was just mad at the world. She's been sick since she was born. She's been through so much and I just couldn't understand why it couldn't be me instead. She doesn't deserve to suffer. I kept saying 'I wish it was me instead of Alani."

Melanie says Alani's response to this helped her put everything in perspective. Alani simply said, "I wish it was nobody." And she told her she was going to be "OK."

Since her diagnosis, Alani has had two bouts of chemotherapy. Her greatest disappointment with the treatment was losing her waist-length hair. Melanie had a series of portraits taken before the treatments so the family could remember what Alani looked like before the Chemotherapy.

"Losing my hair and going through surgery," Alani says are the things she hates most about dealing with having cancer.

After the treatments, Alani has to wear a mask to protect her from infectious agents. "I hate it when people stare at me when I wear the mask in public to keep germs away," Alani said.

To help her feel better, Melanie said on a recent trip to Andy's for a meal with some of Alani's friends, everyone put masks on as well.

"She's tough," Melanie says. "She's hanging in there pretty well."

Since Alani's recent illness, Melanie, who has two other children, a daughter, Lauryn, 12, and a son, Christopher, 14, had to quit her job. This makes it difficult for her to pay for her family's living expenses and other bills.

"I can't just leave my baby," Melanie explains. "She's very sick and needs me."

And Alani does need her mother. Since her diagnosis, Alani received two chemotherapy treatments. During each treatment, she must stay at Pitt Memorial for six days. After that, Alani comes home to allow her body to recuperate from the therapy. Because the chemo destroys good cells as well as bad cells, Alani's body has to rebuild between treatments. Her white and red blood cells as well as her platelet counts and the number of new cells made in her bone marrow must reach safe levels before each treatment. Alani takes three different types of chemotherapy. Because one of these can cause kidney damage, Alani must spend her sixth day of therapy receiving fluids intravenously. Another of the chemicals used can possibly cause permanent hearing loss. And another one can cause nerve damage and the development of leukemia later in Alani's life.

Despite it all, the Byrum family goes on with their day-to-day life and gets by the best they know how. An outpouring of concern from the community has helped a lot, Melanie said.

"Everyone has been so wonderful to us," Melanie said. "I really am grateful for all that everyone has done. I don't know if we could've made it this far otherwise."

Both Alani and Melanie were excited when the Daily Herald contacted them to inform the two that Alani had been chosen as this year's Herald Angel. Through the Herald Angel program, readers and members of the community can make donations for $2 or more and all donors will be listed, along with their contributions in the Christmas Eve edition of the Herald.

Throughout the month of December, each weekend edition of the Herald will feature an article with information about the person or charitable organization chosen as the Herald Angel. At the end of the program, the total donated amount is presented to the Herald Angel.

Readers who would like more information about the program may call Herald publisher Ronnie Bell at (252) 537-2505, ext. 248. Donations may be sent to Herald Angel, P.O. Box 520, Roanoke Rapids NC 27870. All donations are tax deductible and should be clearly marked for the Herald Angel in the memo section of a check. Envelopes should also be clearly marked and addressed to the Herald Angel program.

Next week the Herald will introduce Alani Byrum to readers. We will spend a day with Alani and bring to you, in her own words, just who this vibrant 10-year-old is and how she is coping with her illnesses.

Herald Managing Editor Susan Shaw-Snow contributed to this article