Like all parents, John and Tammy Carver face daily challenges in trying to raise a large brood.
But for the Manchester couple, who have adopted six youngsters from orphanages in Russia and Belarus between 1997 and 2004, those challenges also include helping their youngest child fight cancer.
Juliana Carver, 11, is now in the middle of 36 weeks of chemotherapy, most of which is performed on an in-patient basis at Baltimore's Sinai Hospital.
"I'm a little bit tired," said Juliana, who is being treated by a team of three oncologists. "The hardest part is spending the night in the hospital. (The routine) becomes normal, and I'm used to it. But I just want it to be over. This is the last time, I hope."
In March of 2007, Juliana found a swollen lymph node under her arm. A series of x-rays and an MRI confirmed that she had Stage 3 Alveolar Rhabdomyosarcoma, a malignant and aggressive form that represents 3.5 percent of all cancer cases and most often originates in the head, neck, arms, and legs.
"We thought that this is what happened to other people, and not to you," said Tammy Carver. "It was shocking news, and we couldn't believe it."
Juliana, who was born in Belarus, was 5 at the time.
"I broke down and cried when I heard (that she had cancer)," said Lindsay Carver, 13, who has nicknamed her sister "Fluffy" because of the way Juliana's hair grew back after chemotherapy. "Now, I'm really proud of her, because she's been through a lot."
Juliana began her fight against cancer with six weeks of radiation and 42 weeks of chemotherapy. She also endured two surgical procedures.
The cancer stayed in remission for nearly three years.
But after playing soccer one afternoon, Juliana found a thigh bruise that wasn't going away.
In March 2011, it was determined that the cancer had returned and it was back to the hospital. Juliana endured another 36 weeks of chemotherapy and five weeks of radiation.
"I always say that she's someone who wears Princess and Hello Kitty outfits, but is tough as nails," said Juliana's 13-year-old brother, Timmy.
Juliana, her five siblings, who range in age from 13 to 19, and her parents hoped this would be the end of their visits with oncology doctors, nurses and medical technicians.
On June 6, 2012, the cancer came back. Doctors found a compressed tumor was pushing against her vena cava, the large vein that returns blood to the heart from the head, neck, limbs, and lower part of the body. They also located a chest tumor near Juliana's aorta.
She has four more rounds of treatment remaining, and is scheduled to finish her chemotherapy treatment program in April.
A series of radiation treatments are scheduled to follow.
Her chances of beating cancer are strong. According to the website WebMD, the five-year survival rate for children ages 15 and younger who are stricken by this particular type of cancer is 65 percent.
Help in the fight
When the treatment is finished, Juliana will return to one of her main passions — swimming.
When she was first diagnosed, the Make-A-Wish Foundation built a pool in the Carver backyard.
In addition to Make-A-Wish, Juliana and her family have received plenty of support and encouragement during her exhaustive struggle.
In October, a Hanover-based motorcycle club known as True Brotherhood adopted the Carver family and raised more than $1,000 to help defray expenses.
The local National Football League teams have also lent their support to Juliana's ongoing battle.
During the past three football seasons, the American Red Cross and the Washington Redskins have partnered on a series of blood drives that have netted more than 10,000 units of blood which can be used to help Juliana and other cancer patients. The blood drives were crucial for Juliana, who has received more than 60 blood and platelet transfusions during her ongoing treatment.
"The Red Cross has been very instrumental in making sure that there is enough blood to go around," said John Carver.
"They've told her story in fliers and brochures to put a face on the cause of donating blood," he said. "Most people don't know that each blood donation helps three people."
On Dec. 9, the Redskins honored Juliana at FedEx Field in Landover during halftime of the game against the Baltimore Ravens.
As Juliana made her way onto the field, several fans in the lower deck gave her high-five salutes. A few moments later, she blew kisses to the crowd of over 85,000 as she stood at the 50-yard line.
"I met the Redskins' cheerleaders, and got an autographed picture from them," Juliana recalled. "The team also gave me a football, and I got to sit in a suite."
The Ravens have also been there for Juliana. Responding to a request from the charitable organization Casey Cares, four Ravens helped Juliana celebrate her 11th birthday in her Sinai Hospital room on Dec. 4. She was especially impressed with defensive lineman Arthur Jones.
"It was exciting," said Juliana, her Christmas earrings sparkling as she cuddled her dog Maddie in the Carver living room. "They were there for a while."
John Carver, whose diverse career includes time as an author, insurance sales broker, and retirement planner, is currently pastor of Faith Outreach Chapel in Arbutus. He said the family's belief system has carried them through these rough years.
"Without some sort of foundation, I think we would have lost it a long time ago," he said. "It's been painful. But our faith has a lot to do with how we've handled this. Our kids have been awesome with her illness. They're patient and caring, and do whatever they can to help out."
Juliana's continuing story is being told online at http://www.caringbridge.org and with YouTube videos and messages posted by her father at http://www.youtube.com/johncarver.
"My goal was to create some inspiration and motivation, and to insert a little teaching about life skills," said John Carver, who has authored the non-fiction books "I Believe in You, Volumes 1 and 2" and "Rising from the 'Hood."
"When Juliana started getting sick again, I inserted a section about her battle," he said. "It's reaching about 25,000 people a month, and it could be a lot more if those people are forwarding the information to others.
"It's making a difference in ways that we probably won't ever know."