Chapter 3- Answers and questions.

Rose's POV-

She poked me with a needle, and I closed my eyes and gripped my arm at the pain, I hated shots so much, I don't get how people can stand them. Yeah, I know, seriously awesome badass strigoi slayer can't handle a little prick? Well, I've had some bad experiences with Needles.

Want to know what else I can't handle? My blood test results. "You ready for surgery?" Dr. O asked. My eyes went wide. I really didn't pass the blood test. Holy Shit.

"Umm . . . not really doc. . ."I gulped. I've only had surgery once, after the accident and I had to stay in the hospital for like, a week after that.

At that moment Lissa came rushing into the room, "What happened?" She yelled as she was running in.

I sighed. "Well. . . The doc thinks there's something wrong with me, and I just failed a blood test, now they have to take stuff out of my pelvic bone!" I nearly screamed.

"Rose, just calm down. . . "Lissa urged me, but I just rushed out of the room. "Rose!" She called after me. I felt tears streaking down my face.

Then I ran into Dimitri. Great. I tried to hide the tears and turn away, but he caught me. Just damn great. "Rose, what's wrong?" He asked and put a hand on my shoulder. I shrugged it off.

"Leave me alone." I grumbled. I tried to walk away but he wouldn't let me.

"Roza. Please, what's wrong—"

"Just leave me alone!" I yelled and tried to run, but then he caught me, bringing my lips to his.

"Roza, please tell me." I shook my head.

"Please, just . . . leave. . ."I grumbled.

"Well." He sighed. "That will be easy to do."

"What are you talking about?" I asked him, but I think I new.

"Roza, I'm leaving with Tasha. I'm going to be her guardian. I'm leaving you." I stared at him, hoping he was just joking. Please, someone say he was just joking. I looked like an idiot just standing there, so I ran away, where I was going, I really had no clue, but I'd end up somewhere, right?

And that place was right into Adrian. "Little dhampir, are you okay?"

"No, Adrian, go the hell away!" I yelled and stormed off again. I hated that he just suddenly appeared at the worst times, kind of like Mason used to.

"Sorry, can't do that. I've got to report you back to Doc and Lissa." He picked me up again, but I was so mad that I didn't care. At least I got to be sedated for the surgery. That was the best part about it.

I sighed; "You know, I do know how to walk, like I said earlier today." he just shrugged and carried me anyways. Hey, I got a free ride out of it.

When we got there I had to put on this little dress thingy or hospital gown or whatever it's called. "Got, I hate these things! There so itchy!" There we go, Rose was back.

The sedated me and put me into surgery.

Lissa POV-

I watched as Rose went into surgery. God, she was so brave, I would have never been able to do what she was doing, I would have freaked out. Actually, just watching her do this I'm freaking out.

Please be okay, please be okay. My mind shouted at me. But she had to be okay, right? I mean, she was Rose. Dhampir's barley ever got sick, why should she?

Stop worrying Lissa, she'll be fine. But somewhere I knew it wasn't true. But it had to be. . . Right?

By now I had tears streaking down my face. What if she isn't okay? Is she going to. . . die? No! Lissa, just stop thinking about it. Nothing is wrong with Rose; it's just a minor test, nothing big.

Oh, there's Adrian. "Hey, is she okay?" I asked him, I couldn't stop worrying about her.

"Yeah. . . She's in recovery right now; she's not allowed any visitors. I already tried . . . twice. . ."He sighed. I could tell he'd been crying as well.

"Do you know if. . . Is she okay. . ?"I scratched my head nervously. When he shook his heart I felt my heart shatter.

"No. . . She's not. Doctor says that," A tear escaped his eye. "She has APL. Acute promyelocytic leukemia. A very rare type of Leukemic cancer." I stared at him. Disbelief written all over my face.

"No. . .Not her. . It's impossible. . "I was sobbing now. But the doctor confirmed it. It was true. She handed me a brochure about it.

About APL: A rare blood cancer

Acute promyelocytic leukemia (APL) is a rare but serious and aggressive (fast-growing) form of leukemia which can affect people of any age. The annual incidence of newly diagnosed APL in the U.S. is approximately 1,000 to 1,500 cases, with another 2,500 to 4,000 cases occurring outside the U.S.1

APL is a subtype of the cancer known as acute myeloid leukemia (AML), and accounts for approximately 10% of AML patients.2 APL occurs when the body produces too many immature blood cells known as promyelocytes, which cannot carry out their normal functions and which block the production of normal mature blood cells.

Causes of APL: The role of DNA

During the past few years, scientists have made great progress in understanding how certain changes in DNA can cause normal bone marrow cells to become leukemic cells. DNA is the chemical that carries the instructions for nearly everything our cells do. Some genes (parts of our DNA) contain instructions for controlling when our cells grow and divide. Certain genes that promote cell division are called protooncogenes. Others that slow down cell division or cause cells to die at the appropriate time are called tumor suppressor genes. We know that cancers can be caused by DNA mutations (gene defects) that turn on protooncogenes or turn off tumor suppressor genes.1

Every time a cell prepares to divide into two new cells, it must duplicate its DNA. This process is not perfect and copying errors can occur. Fortunately, cells have repair enzymes that proofread DNA. But some errors may slip past, especially if the cells are growing rapidly.1

Translocations

Translocations are the best known type of DNA abnormality that can cause leukemia to develop. Human DNA is packaged in 23 pairs of chromosomes. A translocation means that DNA from one chromosome breaks off and becomes attached to a different chromosome.1

Signs and symptoms of APL

Acute promyelocytic leukemia (APL) can cause many different signs and symptoms. Many patients will experience several generalized symptoms, such as weight loss, unusual fatigue, fever, and loss of appetite, which are not specific to APL.1 The signs and symptoms specific to APL result from a shortage of normal blood cells due to crowding out of normal blood cell-producing bone marrow by the leukemia cells.1

Common signs and symptoms of APL include:1

Feeling tired or short of breath. This may be an effect of anemia, which is a shortage of red blood cells.

Pale complexion from anemia

Slow healing of cuts or frequent minor infections. APL is usually associated with a shortage of normal white blood cells (a condition called leukopenia) and, in particular, too few mature granulocytes (neutropenia or granulocytopenia). This results in a higher risk of infections. Although leukemia is often a cancer of white blood cells and patients with leukemia may have very high white blood cell counts (leukocytosis), the abnormal leukemia cells do not protect against infection.

Mild fever or swollen glands

Discomfort in bones or joints. Some patients with APL may have bone pain or joint pain caused by the spread of leukemic cells to the surface of the bone or into the joint from the marrow cavity. When leukemia cells spread outside the bone marrow, the condition is called extramedullary spread.

Bruising easily and bleeding. A hallmark of APL is a tendency to bleed. Because of the increased risk of bleeding, there is reason for urgency in the treatment of the disease. The disorder in clotting has historically been called disseminated intravascular coagulopathy (DIC) but is now thought to be a more complicated consequence of the leukemic cells. It can lead to excessive bruising, bleeding, frequent or severe nosebleeds, bleeding from the gums, blood in the urine, and excessive bleeding during menstruation or after needle sticks for blood draws. More serious bleeding may also occur before the disease is under control

Current therapies in APL

Due to advancements in therapies, acute promyelocytic leukemia (APL) is considered the most curable subtype of acute myeloid leukemia (AML).1 Standard therapy for APL is generally a form of vitamin A known as all-trans retinoic acid (ATRA), combined with an anthracycline (a member of a family of chemotherapy drugs that are also antibiotics). With this treatment, 70% to 80% of patients with newly diagnosed APL achieve long-term remission and are probably cured.1

However, despite improvements in therapy, approximately one quarter of these patients relapse and are often resistant to further treatment with ATRA.1-3

Second-round therapies used to involve high doses of chemotherapy, which was often toxic and rarely led to a cure. Bone marrow transplantation may be successful in achieving a cure, but it is an option for only a fraction of the younger relapsed patients.3

Clinical studies of arsenic trioxide have demonstrated high rates of complete remission for these patients, meaning there is no evidence of disease, following treatment.4,5 According to the National Comprehensive Cancer Network (NCCN) guidelines for oncology, arsenic trioxide is the standard of care for patients who have relapsed from, or did not respond to, their initial treatment.6

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(You don't really have to read all of that. . .Just so you know. . maybe I should have put this above, but oh well!)

After reading it, I ran out of the hospital, crying with Christian following behind me. When did he get here? I have no clue.

Skin- Rascal flats

Sarabeth is scared to death
To hear what the doctor will say
She hasn't been well
Since the day that she fell
And the bruise, it just won't go away
So she sits and she waits with her mother and dad
Flips through an old magazine
Till the nurse with a smile
Stands at the door
And says will you please come with me

Sarabeth is scared to death
Cause the doctor just told her the news
Between the red cells and white
Something's not right
But we're gonna take care of you

Six chances in ten it won't come back again
With the therapy were gonna try
It's just been approved
It's the strongest there is
I think we caught it in time

Sarabeth closes her eyes
And she dreams she's dancing
Around and around without any cares
And her very first love is holding her close
And the soft wind is blowing her hair

Sarabeth is scared to death
As she sits holding her mom
Cause it would be a mistake
For someone to take
A girl with no hair to the prom

For, just this morning right there on her pillow
Was the cruelest of any surprise
And she cried when she gathered it all in her hands
The proof that she couldn't deny

Sarabeth closes her eyes
And she dreams she's dancing
Around and around without any cares
And her very first love was holding her close
And the soft wind is blowing her hair

Its quarter to seven
That boys at the door
And her daddy ushers him in
And when he takes off his cap
They all start to cry
Cause this mornin where his hair had been
Softly she touches just skin

And they go dancin
Around and around without any cares
And her very first true love is holding her close
And for a moment she isn't scared

A/N: Very sad chapter, cried while writing it, and it will get worse. When you read this I'd keep a klenex box close by! Sorry about that if it made you cry, if it didn't, sometime in this story you will cry, unless you a heartless. . . something.