Republished online as originally printed in the Post-Gazette Dec. 23, 1997.

The Myers' family annual Christmas letter arrived in friends' mailboxes last week, brimming with tidbits about their spring trip to Ireland, 9-year-old Tyler's trumpet lessons and triumphant soccer team, their second guinea pig, new snake, lizard and two fish.

Not until the fourth paragraph did the letter mention the overwhelming news:

"We found out at the end of July that Alex has leukemia."

Shortly after the letters were mailed, Sharon Myers, the mother of 6-year-old Alex, heard from a college friend with whom she had not been in touch since last Christmas:

"She called me, crying," Sharon Myers said. "She was really upset. I tried not to make Alex's leukemia the focus (of the letter), but I guess it's hard not to take it that way if you didn't know."

• • •

Life for the Oakmont family has been a series of continual adjustments since Alex was diagnosed with the most common form of childhood cancer, acute lymphoblastic leukemia - cancer of the white blood cells - in July.

Alex, who was to start first grade at the Tenth Street School in September, instead was admitted to Children's Hospital in Oakland for the start of a three-year, three-month chemotherapy and steroid treatment program.

Treatments at Children's Marty Ostrow Oncology Outpatient Clinic three times a week became part of life's routine for Alex and his parents, Sharon, 37, and Paul, 36. So did at-home tutoring by Alex's first-grade teacher, Mary Ann Yingling.

When Alex was stronger, he was able to go to school for his class picture, join his classmates, including best friend Tommy Skemp, for a bus ride to a Halloween pumpkin patch and dress as a firefighter for the school party. Not until the class picture arrived did Sharon realize how much Alex had missed. He could identify only a few of his 23 classmates in the group. In kindergarten he knew everyone.

In early September, Sandy Sikora, the school nurse, stopped by Yingling's second-floor classroom.

"Is anybody curious about Alex?" Sikora asked.

One little boy answered:

"I'm curious why he got cancer."

Sikora carefully explained that cancer isn't contagious, but that when the white blood cells "aren't working right, you can get sick."

She told them about platelets, the cells that help in the clotting process, and that Alex needs to take medicine to increase his platelets.

"Alex has to get a special shot sometimes, and so they put a special thing on his side, so you have to be careful about bumping him," she said, describing the plastic device inserted in his chest to enable doctors to keep a vein open for injections.

The children knew that germs are dirty and understood that they shouldn't touch their friend.

"Do you think Alex is lucky because he doesn't have to come to school?" Sikora asked.

Not if he has to get shots, the young students agreed.

Alex began the chemotherapy and steroid treatments at Children's during the last week of July, and almost immediately the disease went into remission. But he requires three years of chemotherapy before he'll be considered cured, meaning the leukemic cells don't reappear.

Leukemic cells can lurk undetected in the spinal fluid, bone marrow or testicles.

During August, Alex had weekly spinal taps and bone marrow biopsies. The procedures got no easier in September as doctors continued the rigorous chemotherapy treatments.

Alex got headaches, and often became nauseated. The steroids made his bones hurt and gave him a voracious appetite.

Some of the chemotherapy drugs attacked his nerves, diminishing his muscle reflexes - a problem that causes constipation and an inability to move his legs quickly. Sometimes, he appeared to be slapping his feet on the floor as he walked. He stayed active, but got headaches.

In October and November, the treatment eased to allow the bone marrow to recover, a period called interim maintenance.

"He used to say `I hate leukemia' and cry. Now, he's more accepting of the situation, but it's also a very good period, a very quiet period. There's no poking or prodding," Sharon said in October.

During this period, two volunteers from the Make-A-Wish Foundation of Western Pennsylvania came to the Myers' home and asked Alex for his special wish. The nonprofit organization grants special requests from children with life-threatening diseases.

The mother-daughter team, Anne Natlis and Linda Bannon, sat at the dining room table with Alex and his family.

"How much money do you have?" Alex asked. "I have a whole piggy bank full."

The volunteers promised that money was no object.

"Make-A-Wish says there's magic in the world for you," Natlis said. She handed him a piece of paper and crayons to draw his wish.

"This is Goofy. And here is Mickey. And here it's Minnie," he said, pointing to the characters.

"Disney World?" asked Natlis.

"Oh yeah!" Alex shouted.

"Yes! Yes!" Tyler added.

Paul and Sharon said that if the treatments proceed on schedule Alex should be able to go to Disney World in Orlando, Fla., next fall. Their first concern was getting through this month and January.

Two weeks ago, Alex entered the "second hit," one of the most intensive drug treatments he'll experience over the three years. The almost daily treatments will continue through next month.

Dr. Jeffrey Hord, Alex's oncologist, said during this period, the boy will receive several news drugs combined with earlier treatments to ensure the hidden leukemic are destroyed.

Alex's hair, styled for him in a Mohawk cut by his father, fell out for the first time last week. Now he chooses from among 24 baseball caps friends gave him.

"I lost it when his hair came out," Sharon said. "I screamed and yelled and cried. I guess I needed to. We've made a big deal about what a nice shaped head he has, and he likes that."

While the drop in his blood counts last Friday was not unexpected because of the chemotherapy, Alex still had to undergo a spinal tap and other intravenous treatments that kept him at the clinic almost all day.

While fluids dripped into his veins, he lay on a table mesmermized by the animated video "Pocahantas" after sorting through baseball cards with his father.

"You're going to have to be here all day. You have to have a spinal tap," Sharon told him.

Alex looked up. "Poor me," he said, before focusing on the video again.

Because his immune system is delicate now, Alex is confined to the house. Today, he finishes four days of at-home chemotherapy treatments administered by a nurse.

The Myers will have a quiet Christmas at home, with the children looking forward to spending the day in their new "jammies" they receive every Christmas Eve and playing with their new toys.

In previous years, they traveled to grandparents' houses in Philadelphia and York for the holdiays.

"I know it sounds weird," Paul said, "but I kind of relish this. We're going to be home together."

Then, on the day after Christmas, Alex will return to the clinic for chemotherapy treatments. For the following four days a nurse will return to the house to administer the chemotherapy.

"There are going to be some really crummy days, but we'll manage, thinking about what we can do to get through that, and to do things for Alex so he feels better," Paul said.

In their Christmas letter, the Myers recounted the year's good tidings: Sharon took Tyler's Brownie troop to camp and the family visited Sea World and the beach, trips they made before their lives were changed. They also tell their friends:

"God has been with us and has given us strength and the peace that passeth understanding. We pray that God is with all of you and gives you that same strength and peace."

• Medical costs: From July 28 to Oct. 24, the most recent doctor and drug bills available: $40,517. As of Dec. 1, out-of-pocket drug bills: $142.17. As of Dec. 19, out-of-pocket doctor bills: $140.

• Health insurance: SelectBlue through Highmark Blue Cross Blue Shield has covered all medical costs, except for nominal copayments for doctors' visits. The Leukemia Society of Western Pennsylvania provides a $750 stipend for parking and incidentals.

• Blood counts when first diagnosed:

- Red blood cell count: 4.9 per deciliter - normal range is 12 to 14 per deciliter.

- Platelet count: 25,000 - normal range is 150,000.

- Absolute Neutrophil Count (ANC), which is the number of white blood cells that can fight germs: Dropped from 320 on July 28 to 100 during the last week of July - good range is 1,500. Anything under 500 is serious.

- White blood cells that were leukemic: 95 percent.

• Blood counts after five months of chemotherapy and steroids:

- Red blood count: 11.9 per deciliter.

- Platelet count: 124,000.

- Absolute Neutrophil Count (ANC): 900, which is just below the "be careful" zone.

- White blood cells that were leukemic: None visible.

• Chances of survival: 92 percent, based on his response to chemotherapy and steroids.

For more information, call:

• American Cancer Society, patient services: (412) 261-4352.

• Burger King Cancer Caring Center, (412) 622-1212.

• The Candlelighters Childhood Cancer Foundation, (412) 344-9823 or (800) 366-2223.

• Leukemia Society of America, Western Pennsylvania chapter, (412) 395-2873 or (800) 726-2873.

• Leukaemia Resarch fund web page, www.leukaemia.demon.co.uk/index.htm