Part 1 of 2 in a series about pediatric cancer.

Four years ago, Damian Richards was a healthy, active 17-year-old .

A senior at Marian Catholic High School in Hometown, he excelled in athletics and academics and played football, basketball, baseball and ran track.

“I was literally the kid who never missed school because he was sick,” said Damian, the son of Jeanette and Ralph Richards of Jim Thorpe. “I’d only miss to go somewhere cool with one of my brothers.”

But one morning, Damian was too sick to get out of bed. His mother, a nurse practitioner, thought he might be getting the flu, so she gave him fluids and told him to rest. When there was no improvement, she tried antibiotics, but nothing helped.

On the third day, he rallied to go on a family trip to New York, but while there, he developed a stabbing pain in his abdomen that he rated a 10 out of 10 on a pain level. They left New York immediately, and his parents took him directly to the emergency room.

The hospital kept him overnight, but when they could find nothing wrong with him, he was released the next day.

Damian’s condition worsened.

“I couldn’t even stand up because I was in so much pain. By the end of the day, it spread to my arms, legs. I couldn’t move.”

Back at the emergency room, a blood work-up showed that Damian’s liver enzymes were 4,000 points higher than normal, which is a sign of acute liver failure. An ultrasound and CT scan determined that he had mesenteric lymphadenitis throughout his system. His lymph nodes were so swollen and inflamed, they were pressing on his organs, and in particular, his liver and spleen, which was what was causing the accelerated liver levels.

He was admitted to the pediatric ICU.

“They tested me for everything in the book,” Damian said. “Nothing came up. They were absolutely baffled.”

During his 11-day hospital stay, Damian turned 18.

“They woke me up at 4:30 in the morning and had about 30 lab vials to draw blood, and they had tied a nice bow around them as a joke for it being my birthday.”

In the meantime, Damian said the pain was still excruciating. Narcotic painkillers didn’t help. Nothing helped until the swelling went down. When his symptoms subsided, he was sent home, but with no real reason as to why he’d gotten sick.

Still no answers

Damian felt good. He graduated high school and started college at Bloomsburg University. He had regular follow-ups, including another ultrasound and a biopsy in the fall, which came back with no concerns. And while he had a swollen lymph node in his neck, it didn’t hurt. The doctor said it would go down in time.

But it didn’t.

When Damian returned in January for another follow-up, and the lymph node was still swollen, he was scheduled for surgery two days later.

Although nothing was said to him following surgery, his parents were told that the lymph node didn’t look normal and it would be sent to the National Institutes of Health for pathology.

“One, two, three weeks, then two months go by,” said Damian. “They told us they were still working on it.”

Damian’s mother was employed by Bloomsburg University at the time.

“I was in class,” Damian said. “She called and asked me where I was, and said ‘I need to see you.’ I went to see her in her office, and she told me it was cancer.”

Although he’d felt fine since he’d first gotten ill a year earlier, Damian was diagnosed with pediatric follicular non-Hodgkin Lymphoma, an extremely rare form of cancer.

“I lost it for a little bit,” he said. “Who wouldn’t?”

The pathology on Damian’s cancer took as long as it did because it was so rare. There was also only one doctor who could treat it, and she was at Children’s Hospital of Pennsylvania, so off he went.

“I went from a normal college kid to taking off from school to go to CHOP, and I have cancer. A whirlwind of thoughts were going through my head.”

Damian’s oncologist surprised him when she told him he was lucky.

“She told me my cancer was so rare, I had a better chance of being hit by a truck, bitten by a shark and struck by lightning, all at the same time. Then she proceeded to tell me why I was lucky.”

Her research, along with that of her colleagues, had recently determined that it was better to do surgery for Damian’s form of cancer instead of chemo and radiation. They found that chemotherapy was killing more people than the cancer.

Damian had already undergone surgery to remove the affected lymph node, so the protocol was to wait and watch.

Looking toward the future

Since his diagnosis in 2014, Damian has regular CT and PET scans to determine if there are any malignant lymph nodes in his body. The scans have always come back negative, but it’s not really over.

“The hardest part for me with this whole thing is the psychological part. It’s not a cancer that can be cured. They can’t promise it won’t come back when I’m 32 or 24 or 58.”

Damian said it can be difficult to translate his thoughts about having cancer into words.

“Sometimes you’re on top of the world. You think ‘I can beat this.’ And sometimes you’re super scared and don’t know what to think. It’s not like an impending doom, but a dark cloud that hangs over your head. It is very, very nerve-wracking. It’s like a roller coaster. The highs are high and the lows are super low.”

In May, Damian graduated from Bloomsburg. He’s a registered nurse in the adult intensive care unit at Geisinger Medical Center in Danville.

“Sometimes it’s hard for me at work. I’ll have patients with a form of Non-Hodgkin lymphoma, and they’re not doing well.”

And that, he admits, scares him.

“My job is one of the ways I cope with my diagnosis. It’s something where I can make a difference with other people and show my gratitude for my well-being. When I take care of people who aren’t as fortunate as I am, it gives me perspective of how lucky I am, and that I’m meant to do something bigger and better, and that’s why I’m doing well. It gives me that silver lining.”

Damian has advice for anyone who becomes a cancer warrior.

First, take advantage of the unlimited resources that are available and investigate the research, which is ongoing.

And second, never say you’re a survivor and never say you’re a fighter.

“If you say you’re a survivor, that means it’s over, and it’s never really over. And if you say you’re a fighter, there’s always a chance you could lose.

“But if you say you’re a prevailer, the only way to go is forward.”

Not long before his 18th birthday, Damian Richards became gravely ill.

The son of Jeanette and Ralph Richards of Jim Thorpe, Damian was a senior at Marian Catholic High School in Hometown when he first got sick in March of 2013. He was a healthy, active 17-year-old who excelled in athletics and academics. He played football, basketball, baseball and ran track.