Ten-year-old Reagan Claire Smith is happy that people know her for her singing, rather than for being sick.
"We came to Packard Children's in 2009 when Reagan was 6 and in the first grade," said her mother, Sandra Smith. "All of a sudden she had big, dark purple bruises and pinprick marks all over."
Hematologist Bert Glader, MD, PhD, diagnosed the bruising as immune thrombocytopenic purpura, or ITP, characterized by a big decrease in the platelets essential for blood clotting. This meant bleeding under Reagan's skin. "She was so fragile that if she was hit in the head, it could result in bleeding to the brain," said Sandra.
"I was really upset at not being able to play the way other kids did," added Reagan, who wasn't yet known as a singer.
Of unknown origin but perhaps triggered by a virus hitting the immune system, ITP is usually short-lived. But not this time. Normal platelet counts range from 150,000 to 450,000 per microlitre of blood. Reagan's were often less than 10,000. That's what caused the bleeding.
Reagan's treatment included medicines, hospitalizations and chemotherapy. Nothing fixed the problem. Even a paper cut could send her to the emergency room. "We decided to do something definitive to help her regain her quality of life," said Glader, who is also a professor of pediatric hematology and oncology.
That meant removing Reagan's spleen, the site of platelet destruction. In 2010, minimally invasive surgery expert Sanjeev Dutta, MD, removed the organ through the girl's belly button in a no-scar procedure. "Since that time, she's been in remission and has definitely gotten her life back," said Glader. Reagan's platelet counts have returned to normal and her activities are no longer restricted. The only drawback is that she lost the spleen's ability to fight some infections and so needs prompt medical attention for fevers, which can signal infections, Glader said.
While Reagan's health was down, her singing was up: Her career unofficially launched at age 7 when she sang "Come Just as You Are" during Mass. "People said she brought tears to their eyes," said Sandra, who had no idea of her daughter's vocal power. The Sacred Heart Schools community started a prayer team for the girl who wasn't even allowed to ride a bike, and her illness inspired a blanket drive to assist children in need.
Word of Reagan's talent spread. She appeared at "Glee by the Bay" and the Herbst Theater's "That Kid Can Sing," and was the youngest of three winners in a 2012 competition of over 1,000 singers throughout California.
"Reagan is the youngest artist I've ever signed to my music company," said "I Wanna Know" producer Patrice Wilson. "She's a very talented person."
With her bruises gone, Reagan's now deep into volleyball, track, horses and a brand-new bike. "But what I like most is singing," said Reagan, who plays piano by ear and digs Bruno Mars. She's especially thankful to Packard Children's and is donating iTunes proceeds to the hospital's Bass Center for Pediatric Cancer and Blood Diseases.
It all seems like a great start to her "singing doctor" career. "That's really what I want to do," said Reagan excitedly. "I'd like to maybe be a surgeon who works with kids and then sings on the side."
"Our team has a lot of experience with cases like this," said Glader, who confirmed that he's planning to add Reagan to his iTunes playlist. "Helping to normalize a child's life is a guiding principle in everything we do, and we're happy to make this happen for such a talented young lady."
Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu/.
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