More Life-Altering Than Cancer?

On May 7th 2009 I went in for a simple surgery to reposition my port-a-cath, and was asked to give a urine sample. As I sat, waiting for my surgeon to arrive, the anesthesiologist dropped by to tell me we might have to cancel the surgery. When I asked why he explained that the urine sample had tested positive for pregnancy. Peter and I laughed and shook our heads. No way could I be pregnant! I hadn’t had a period since I started chemotherapy 4 years ago. I had gone through chemo-induced menopause, or chemo-pause as I liked to call it. Periods stopped, hot flashes, night sweats, the whole works. My ovaries had closed the doors and gone out of business. Clearly this was a case of a false positive, because it wasn’t even possible.

That wasn’t enough to convince him so I said that in March I had a whole slew of tests (MRI, CT, PET) and the radiologist noted some fluid in one of my ovaries, “possibly related to menstruation.” My oncologist thought it was nothing, but since it wasn’t his department he suggested I follow up with my primary care physician. I saw my PCP the next day and she reassured me that with my history, it was probably just an anomaly. She went on to explain that she saw these things all the time and they tended to be nothing to worry about.

By the time I finished explaining all of this, my surgeon showed up and we explained again why there was no way I could be pregnant. I’ve known my surgeon since the day I was diagnosed because they sent me directly from the mammogram to her office for a biopsy. She is genuine and kind and the most personable doctor, let alone surgeon, I have ever met. Knowing me and my case she also thought it was a false positive but needed to be sure before going ahead with the surgery. Our options were to draw blood and await those results, or try to arrange an emergency sonogram.

While they were trying to figure out which would be quicker, my surgeon decided to contact the radiologist and have that doctor take a second look at the scans from March. He concluded that with my history, it was very unlikely that the fluid on the scans was a fetus, but if it turned out to be positive, then the fetus was about 6 weeks at the time of the scan, and about 13 weeks now. Despite the radiologist’s confirmation of his original report, my surgeon wanted to know for sure, so I was whisked away for a sonogram.

It was in that darkened room, with Peter sitting to my left and a sonogram technician waving a wand across my belly that we saw on a small TV, the tiny head and glowing spine of a 13 week old fetus. Holy shit!

At that point Peter and I were stunned senseless and freaked out beyond words. This was the biggest shocker since my cancer diagnosis and I dealt with it in much the same way: disbelief, tears, and a hell of a lot of fear. My surgeon called my oncologist to tell him the news and his response was, “How did this happen?” To which my surgeon responded, “What do you mean?” We all had a little chuckle, but it did nothing to ease the tension everyone felt. The surgery was called off and I was scheduled to see my oncologist later that day because we had some questions that needed answering. Unfortunately, answers weren’t easy to come by.

“How is this possible?” It turns out that pregnancy was only extremely unlikely not completely impossible. A very small number of women undergoing chemo have gotten pregnant, and an equally small number of women who didn’t have regular periods have also gotten pregnant, so pregnancy for me was still in the realm of possibility. This is a realm where getting bitten by a shark or struck by lightning are also, theoretically, quite possible.

“Has this ever happened before?” My oncologist did not have any personal experience with pregnancy and my chemotherapy medication, Herceptin, but he looked into it and within a week he had found only 5 known cases of women on Herceptin becoming pregnant. With such a small number of women, and only anecdotal information, this news did nothing to help us make the most monumental decision of our lives. Should we keep the baby?

“Has the Herceptin hurt the fetus?” This question could only be answered by an OB/GYN and the one we met quickly passed us on to a Parinatologist, or high-risk pregnancy doctor. This doctor had done the research and come up with the exact same 5 cases as my oncologist. In two of the cases, the pregnancy was normal and the baby healthy. In another two cases, the pregnancy was difficult but the baby was still normal. In one of the cases, the baby didn’t survive the pregnancy. Not the greatest news, but not the worst either.

“Have any of my other medications hurt the fetus?” My anti-seizure medications are Class C medications, meaning that their potential harm is unknown or inconclusive. Most anti-seizure drugs are Class D, which is definitely all bad, so I lucked out there, or rather, the baby did. The other drugs I take aren’t great, but not specifically harmful, so that was one less thing to worry about.

“What about all the radiation?” This one was a big worry for awhile. The scans I had back in March, exposed me to quite a bit of radiation. Then I had Gamma Knife Radiation to zap away a small brain tumor in April. The Parinatologist did research on the effects of radiation on pregnancy after the bombing of Hiroshima, Japan, and that was all we had to go on. He felt that the scans, while generally avoided during pregnancy, were of such a low amount of radiation (compared to Hiroshima) that the baby was probably okay. In his opinion, if the radiation had hurt the baby, the baby wouldn’t have survived the first trimester.

This was all the information we had to go on to make a decision about whether or not to keep the baby. All of this information gathering took several weeks, and we needed to make a decision before it was too late. There were so many things to weigh. How would we afford it? What if it wasn’t healthy? What if I got sick? What if my next brain tumor was inoperable? What if the cancer came back? What if I died? It was a gut wrenching, heart breaking, and overwhelming decision to make. Having a baby is a big decision for everyone, but when the additional stresses of my existence were thrown in, the decision became as seemingly impossible as the pregnancy itself.

Ultimately, our decision was to continue the pregnancy. For once, in this whole mess of living with cancer, something potentially wonderful has happened. A baby gives new meaning to life, and the amount of joy it could bring to both Peter and I is immeasurable. We’ve been through so much disappointment and devastation since my diagnosis that maybe bringing a baby into the world will balance the scales a bit. Besides, the baby had already been through so much, and so clearly had a fighting spirit and will to live, that we felt it deserved a chance to do so. Our decision also rested on love. Both the love we have for each other, and the love for the baby that grows each day that passes.

As I write this I am now at 22 weeks, and just starting to feel the baby move. The baby is a girl and we’ve chosen the name Anya Lee. We both really liked the name Anya, and Lee was my mother’s middle name. The pregnancy is turning out to be a difficult one. In those two cases of difficult pregnancy on Herceptin, the problem was a low amount of amniotic fluid. I was checked every two weeks, and sure enough, the fluid started to drop. It is at the very low end of normal, and if it goes any lower it could harm Anya, so now I’m checked every week. Luckily, we know from those other cases that if we increase the length of time between Herceptin treatments, the problem will likely resolve itself. So we’re watching and waiting and hoping that things stay as they are or get better on their own.

I am looking forward to the future. I look forward to meeting my baby girl and showing her the world for as long as I am able. I know my life is about to change dramatically in a way I cannot imagine, but if having cancer has taught me anything it has taught me that I have a pretty remarkable amount of strength, will-power, and courage. I can only hope I have enough to cover me, Peter, and Anya.