The first hospitalization of a child with primary leukemia can be a time of great crisis, and when we talk to parents, we often refer to this hospitalization as “breaking through the ghost gate”. What are the hurdles that must be overcome? And how do you go about it? Today I would like to talk to parents about this topic and hope that my experience will help you to accompany your child through this important and difficult period. The first hurdle: the psychological hurdle The diagnosis of leukemia is no less psychologically devastating for children than it is for parents. Children will also go through periods of depression, anxiety, and irritability in turn, until they calmly accept the disease. How can we help our children get through the psychological downturn? First of all, parents themselves have to adjust their mindset as soon as possible and infect their children with optimism and positive emotions. In the escort ward, any slight mood fluctuation of parents will affect their children. In my work, I found that in those cheerful and open-minded families, the child’s recovery is faster and the treatment process is relatively smoother, and vice versa, the child’s treatment process may be more difficult. Secondly, children can communicate with their friends, especially those who have successfully overcome the disease, and use their personal experiences to tell them that leukemia is not a scary disease and that it can be overcome. In addition, you can also seek psychological support from the doctor in charge. Sometimes, a word of affirmation and encouragement from the doctor can be as effective as the words of the kindergarten teacher. The second hurdle: diet One of the biggest concerns parents have during a hospital stay is their child’s diet. I find that our parents often go to two extremes. One group of parents is very anxious when their children are sick, so they make a lot of big fish and meat for their children at once to make up for it; the other group of parents thinks that since their children have no appetite, they should just make them some light soup and gruel to drink. In fact, the general dietary principles during hospitalization: fresh, clean, low sugar, low fat, easy to digest, avoid eating raw, hard, irritating food, but also to ensure that there is a certain amount of nutrition, in order to increase the child’s immunity. As for what specific meals to make, they can be adjusted according to the child’s preferences as well as appetite. Parents of new patients can also learn from the parents of old patients and exchange cooking tips. If you are not sure what you can and cannot eat, be sure to seek the advice of your doctor. The third hurdle: chemotherapy The chemotherapy drugs applied to a child with leukemia for the first time in the hospital are often strong and intensive, so the child may have a variety of different chemotherapy reactions, ranging from vomiting and hair loss to organ damage. Fortunately, with the development of pharmaceutical technology, a variety of advanced protective support drugs are now available to help children minimize chemotherapy reactions, reduce organ damage, and get through each chemotherapy period safely. Moreover, compared with adults, children do not have underlying diseases such as hypertension, heart disease and diabetes, and are less psychologically stressed than adults, and often have less severe chemotherapy reactions than adults. It is worth mentioning that some parents always think that their children’s chemotherapy reactions are not good if they are light, and they worry that their children will not survive the heavy chemotherapy reactions, so they are always obsessed with these things, but in fact, it is not necessary, the chemotherapy reactions have obvious individual differences, and there is no obvious correlation with the treatment effect. The fourth hurdle: the infection hurdle This hurdle is a fairly important hurdle that most children must pass during their first hospitalization. The average child is able to recover quickly after a general infection due to a certain level of autoimmunity. However, for children with blood disorders, due to bone marrow suppression after chemotherapy, white blood cell counts drop significantly and immunity is poor, serious infections often occur, and they are prone to complications such as sepsis and infectious toxic shock. This requires parents to be very careful when caring for their children, try to fix special care, reduce visits, strict sterilization of meals, the child’s mouth, perianal, fingernails and other areas prone to infection must be carefully cared for. Eat more fiber-rich foods to ensure smooth bowel movements and prevent constipation that can lead to anal fissures. During the treatment of leukemia, we also regularly let the children take a drug by mouth: cotrimoxazole, which is a special drug to prevent Pneumocystis carinii pneumonia, and we usually let the children take it by mouth 3 days a week. During the period of taking this medicine, children should be allowed to drink more water and also take oral sodium bicarbonate to prevent kidney damage. The fifth hurdle: bleeding hurdle This hurdle is a particularly dangerous one. At the beginning of the disease diagnosis or during the treatment, due to low platelets or abnormal coagulation function, children may have various degrees and different parts of bleeding, some manifesting as nose bleeding, gum bleeding, some manifesting as hematuria, black stool, and in serious cases, brain bleeding. Parents can give their children nasal drops with peppermint oil drops and strictly forbid them from picking their nose to prevent nasal bleeding. Pay attention to observe whether the color of urine and stool is abnormal. Pay attention to the child’s mental awareness and report to the doctor as soon as you find that the child is sleepy, irritable, or in bad spirits, and that the child has abnormal crying. In the fight against the common enemy of leukemia, parents and doctors are all close comrades in the same trench, and when we all put our wisdom and strength together, what can’t be destroyed? Let’s join hands and help our children overcome the five hurdles together