The Countdown to Baby Begins!

lil' pumpkin for the Pumpkin :)

I've spent the past few weeks working a little bit, while balancing an increasing number of doctor appointments.  We're approaching my last AC chemo treatment and are beginning to pinpoint the safest timeframe to schedule Sweet Potato's induction at around 35-36 weeks gestation.  

Some people have wondered why I have to be induced.  Basically, my treatment team would like me to move to the next step of treatment as soon as possible, which involves 12 weekly rounds of Taxol, a chemo drug that is unsafe for baby.  Chemo is more effective when it's administered consistently and in a cumulative manner.  If we waited until I was full-term, too much time would lapse between treatments, which is no bueno.  Not to mention, my cancer is stage 3 and pretty f***ing aggressive, so we need to keep this train moving so I can get on with living!

Therefore, I'll be induced on November 18th, allow some time for recovery, and then immediately start the Taxol.  Babies born at this gestational age tend to do fairly well, and though there's a possibility that he might spend a day or two in the NICU, it's just as likely that he won't need to go there at all.  The plan is to have a normal delivery, though obviously a c-section will be the back-up plan if there are any complications.  

Here are some highlights from the past couple weeks:

10/20/14:  Today Jeremy had the day off, so I tagged along with him to his appointment with our primary care physician.  He wanted to get a flu and T-dap shot, which are recommended for anyone planning to be around infants in the near future.  It was weird to not be the patient for once!  Due to chemo, I'm not able to get these vaccines until I get clearance from my oncologist.  Last time Jeremy was here, he passed out like a sack of potatoes after they did bloodwork, so today the doctor and his office staff didn't hesitate to jokingly remind him about it.  He's kind of a legend there now.  Our doctor also provided a good recommendation for a local pediatrician, where he personally takes his own children.  Lately we've been so concerned just managing our day to day lives that we haven't given as much thought to all of the things that need to be done once the baby is actually here.  We gotta get into parenting mode, quick...

About an hour later, we headed to another appointment, this time my OB.  They set me up for something called a non-stress test.  This is a simple procedure that's used to monitor the baby's movements and heart-rate.  It's called a "non-stress" test because it doesn't bother the baby at all.  But I have to say that it was a little stressful for me!  First, they place a monitor on your belly to listen to baby's heartbeat, and another monitor to check if you're having contractions.  Then, they give you a hand-held clicker (like the buzzers on Jeopardy) and instruct you to press the button every single time you feel the baby move. Ideally, baby's heart-rate should accelerate with each movement, which would indicate that they're getting enough oxygen.   The nurse leaves the room for twenty minutes or so and the pressure is on! With every little movement, I had to decide...was that the baby moving, or just my stomach growling?  At times, Jeremy would try to talk to me and was quickly shushed.  If this was a test, me and the baby were going to get an A+, dammit! After 20 minutes, the doctor came in and reviewed the data. She was able to see a few accelerations of the heart-rate that correlated with when I pressed the button, and was satisfied with the results. I'll be getting this test done twice per week from now on, to ensure that things continue to go smoothly.

10/21/14:  I had a call from the OB's office, saying that they'd like me to start checking my blood pressure daily.  They also sent in a script for a 24-hour urine test, which detects if there are elevated proteins that indicate blood pressure problems. Apparently, my blood pressure was slightly elevated when she checked it yesterday, so she decided to take a few extra precautions to make sure I'm not developing preeclampsia (simply put-high blood pressure during pregnancy).  Not sure why all of this was brought up after the fact and not during my office visit?  Guess my bodily fluids are in high demand these days. 

The next issue was trying to figure out when I could feasibly take this test.  You basically have to fill a jug with your urine every single time you go, for 24 consecutive hours.  It has to stay refrigerated.  It has to be dropped off at the lab as soon as the 24 hours are up.  You then have to stay at the lab for complete bloodwork.  Looking at my parade of appointments over the next week, not to mention the weekend, when the lab is closed, there weren't any days where I could take this test.  And with another chemo coming up soon, I wondered if those medications would alter the results of the test.  So many variables to consider, it makes my head spin.

10/22/14:  Today was another ultrasound with the maternal-fetal-medicine specialist. Jeremy and my dad came along this time, who had never seen an ultrasound before.  He spent most of the day in anxious anticipation (love you, dad!).  The ultrasound was great and we got good news all around from the doctor.  Currently, baby's weight is estimated to be about 4lbs, which is right in the average range.  We also discussed my glucose screening results from a few weeks ago. Instead of sending me for a 3-hour test, she suggested that I simply start checking my sugars at home 4 times per day.  Though this might seem more inconvenient than a one-time test, I feel more comfortable tracking things this way, so she wrote a script for a home testing kit.  She's curious to see how the chemo drugs and steroid medications will affect my sugar; she hypothesized that my sugars will increase, so she's kind of using me as a guinea pig to see if this will be the case.

10/25/14:  All of this testing business was put aside for the weekend, as it was time for our baby shower!  My mom, mother-in-law, sister, and brother all worked together to create a really special day for Jeremy and I.  Words can't express how bittersweet it was that so many people took time from their busy lives (and drove from near and far...and some from very, very far) to show their support and love for us. It was a rollercoaster of emotions as we celebrated one of the happiest times in our life, in conjunction with the biggest challenge we've ever faced.  Our baby boy has absolutely everything he needs, and already knows how much he is loved.  To those of you who were able to share this special day with us...thank you.  And thanks to the many of you who were there in spirit <3

10/28/14:  I got the all-clear to go ahead with my 4th chemo treatment, yay!  This will be the last one for Sweet Potato to endure.  I'm so proud of him for staying strong and going through this with me.  I truly believe that somehow we've managed to protect each other from all of the crazy things that chemo can do to you.  Side effects haven't been nearly as rough as I expected them to be and though a part of me keeps waiting for the other shoe to drop, overall I feel very lucky.

Hooray for baby's last chemo!

My view for the day.

My most favoritest nurse accessed my port with ease (seriously, she is the best).  I casually asked if she'd be working on Friday (Halloween...good times), when I come back for IV fluids, as that's when I tend to run into issues with the port.  She said she'd be there, and we had a silent wink-wink understanding that she'd be the one to access my port again, which was a big relief.  The next 6 hours passed with minimal drama and I headed home feeling super sleepy.  Thanks mom for coming along with me :)

My blood pressure has been perfect since I started tracking it about a week ago, usually averaging around 115/76.  And so far, my sugars have been on track as well (once I figured out how to correctly use the testing kit).  Ain't nobody got time for gestational diabetes! However, now that I've just completed a chemo treatment, the levels are expected to fluctuate for a couple days.

When I got home from chemo, I was greeted with a very special note...

So there you have it.  "Sweet Potato" officially has a name.  Benjamin David, we are counting down the days to finally meet you.

Keep Calm (and try not to pass out)

Over the weekend before my 3rd chemo, Jeremy and I signed up for a group tour of the Labor & Delivery unit at the hospital where we'll finally meet our Sweet Potato!  We made it a "date day" by going to lunch and a movie before the tour, which was on Sunday afternoon.  The official guide called in sick that day, so we had a haphazard tour by a nurse who essentially read notes from a piece of paper at lightning speed.  In any case, it was nice to get a sneak peak at the rooms and familiarize ourselves with the whole process.  I've heard great things about the unit (which is at the same hospital where I go for chemo), so despite the underwhelming tour, I'm still excited and optimistic that we'll have a great experience there.

That evening, I started to feel a little sick, and woke up in the middle of the night with what I'll vaguely describe as "gastrointestinal issues."  I was also nauseous and just generally not feeling like myself.  I had an appointment with my oncologist that Monday morning (10/6), so I let him know about my symptoms.  But, he didn't seem too concerned, as I didn't have a fever.  He suggested that perhaps I was getting a little nervous, since it was the day before my next chemo.  I had labwork done and went home to rest for a few hours before my second appointment of the day at the OB.

That afternoon, I had my monthly prenatal exam.  I'm 30 weeks now and the belly is really starting to show itself!  My mom came along and got to hold the doppler to find baby's heartbeat, which is always music to my ears.  I learned the results of the glucose screening test that I took the week before.  Most tests have a cut-off of 140, meaning that in order to pass, your results have to be less than 140.  But for whatever reason, the test I took has a cut-off of 135.  My score?  137.  So, that meant I "failed" by TWO POINTS!  Not what I wanted to hear, as this basically means more bloodwork, and more trying to figure out when I'm feeling "well" enough to go and take the test.  I'm irritated that by most standards, I was within the normal range!  The 3-hour test involves fasting and then getting blood drawn every hour, for 3 hours.  Most people will switch arms for each draw, to give their veins a break.  But, I'm only able to have blood drawn from one side, so this is another concern that makes me incredibly not-excited to take the test. Scar tissue is already starting to develop around the veins in my "good" arm, due to all of the labwork. Ew.

Needless to say, I left the OB appointment feeling a little annoyed.  I also still felt sick and just wanted to go home and try to sleep it off.  I laid down around 4pm, and was down for the count.  I continued with the stomach issues, nausea, and now had a headache and fever that was creeping up.  Jeremy monitored it every hour, as I'm supposed to contact the oncologist if it reaches 100.4 (this would be a sign of a developing infection, which would be bad news the day before chemo).  Luckily, it only reached 100.1 and then began to taper off.  I continued my marathon sleep session and hoped that I'd feel better in the morning, because if not, the chemo treatment would probably have to be delayed.

Charley, my napping buddy <3

I felt substantially better on Tuesday morning, and was able to go ahead with treatment as planned.   My vitals were good, though the nurse noted that my pulse was high, around 123.  This time my dad got initiated into the "chemo club" and I must say that I'm very proud of him!  Not many dads have to deal with two daughters simultaneously going through cancer treatment, and I'm lucky my parents live nearby and are ready and willing to help out any way they can. We settled in for our 6-hour session and earned a Starbucks on the way home.

For the next two days I felt pretty good, all things considered (this is likely due to the steroid pill that I take on the two mornings following each chemo).  On those days, I am pretty much a hermit and don't leave the house.  On Friday (10/10), my dad took me back to the hospital for IV fluids.  The nurse had a hard time accessing my port again, which has happened one other time when I came in for fluids.  She could insert the needle just fine, but couldn't get a blood return.  Two more nurses were called over to troubleshoot, as well as a student nurse who was there to observe.  Because the port is located between my armpit/neck, the nurses have to lean in really close to get the job done. So, a tiny room with four nurses in my face, plus my poor dad who was just trying to stay out of their way...I quickly started to feel lightheaded and sweaty.  I asked for some water and then said I felt like I might vomit.  I commend the student nurse who did a stellar job fetching me a barf bag.  Everyone started moving slowly and their voices became very faint and that's when I realized that I was about to pass out!  Thankfully the nurses also realized what was happening and were able to intervene to keep things from getting to that point.  They theorized that maybe the reason they're having trouble with the port is because I was dehydrated.  Despite drinking a ton of water, I should probably drink even more, because afterall, I'm sharing it with the baby :)  So, I ended up with a regular IV, and was given some breathing room.  Kudos to my dad for keeping calm, cool, and collected!  I'm glad I could provide some entertainment for everyone.

After a few hours on the IV drip, it was time to go home.  But, I heard some chatter near the nurse's station about how they couldn't let me go home until they messed with the port again.  Apparently, they needed to flush it out with Heparin, a drug used to prevent blood clots.  They couldn't send me home without doing this.  I also heard mention of trying it with the "long needle."  My dad and I looked at each other wide-eyed and I yelled to the nurse that a short needle would work just fine!  Luckily, my favorite nurse took the lead this time; she has a way of calmly explaining what she's doing and I feel much more comfortable when she does it.  And finally, SUCCESS!  I should add a disclaimer that having a port is actually a good thing.  Most of the time, it works like a charm and is essentially pain-free.  I don't want to unintentionally scare anyone who might be getting a port...they really are great :)

My brother-in-law had a little setback right around this time.  It's been over two months since his open heart surgery, and he'd just been given the all-clear to return to work when he experienced some weird feelings in his chest.  He went to the ER and ended up being admitted overnight.  After a bunch of tests they were able to pinpoint that nothing major was wrong, but rather an issue that could be addressed with a medication adjustment. We were worried about him but are happy that everything is ok and he's back home!  My sister has her 5th chemo tomorrow...so please take a moment and send some good thoughts her way. She's on the home stretch now!

Chemo Brain + Pregnancy Brain = Where did I put the milk cap?

First off, October is Breast Cancer Awareness Month, so....yay for that!  However, I consider July to be the month that I became "aware" of breast cancer, so even though I'm glad this month will bring attention to the cause, I'm not a huge fan of companies jumping on the pink bandwagon to try and drum up business under the guise of charity.  In meeting other women with breast cancer, I've realized that this month is actually a very emotional time for many of them, having to see reminders EVERYWHERE; you can't even buy a can of soup without seeing pink ribbons plastered all over the packaging!  It makes you wonder how much of the proceeds actually end up in the right place.  And tongue-in-cheek phrases like "Save the tatas" take on a different meaning when you weren't able to save your own.  While that sort of thing doesn't personally bother me that much, I definitely have a new perspective for women who might take issue with it.  So I guess my advice is:  see your doctor right away if you ever suspect anything is wrong, do your research before blindly supporting or otherwise donating to companies who claim to support breast cancer research/awareness, and maybe take the pink-ness overload down a notch :)

My second round of chemo was on September 16th.  I met a 24-year-old going through treatment... shoot, I thought I was young!  She was just starting her first round of Taxol, which is the next medication I'll start immediately after I have the baby.  Turns out we have the same team of doctors, and we both have a thing for Disney (she got married on a Disney cruise and I got married at Disney World).  We compared our wedding pics and our side effects and our opinions of our doctors and then went on our merry way like this was a totally normal interaction.

This time around I definitely experienced a lot of fatigue, starting two days after treatment.  I went into a sleepy fog, and slept off and on for several days.  The weather was also rainy/cloudy during this time so that definitely contributed to my reluctance to get out of bed!  I returned to the hospital for IV fluids on 9/19 which went off without a hitch.  After that, my mom and I (tiredly) drove to an appointment to get fitted for a prosthesis. This basically consisted of some new bras and a silicone "chicken cutlet" that makes me look considerably less lopsided in comparison to the sad little temporary insert that I got right after surgery. Luckily, my insurance covered the fitting because I'm sure if I had to pay out-of-pocket the going rate would be something like one milllllllllion dollars (cue Dr. Evil voice).

I'm getting used to my hair (or lack thereof).  Though I haven't ventured out in public yet without wearing a hat, I must say that it feels nice to not have to go through the daily annoyance of washing/drying/straightening/brushing my hair.  The hair loss has slowed down in the past week or so.  I can't tell if it's trying to grow back already, or if it's just at a standstill?  In the meantime, Jeremy thinks my head feels like a fuzzy baby bird.  He tells me how pretty I am and I'm 99.9% certain that he genuinely means it and isn't just feeding me lines. :)

Best quilt ever.

On Monday 9/22, I had a followup and bloodwork with the oncologist at 9am.  I was feeling motivated that morning and actually saw a client beforehand, so that I could just go home and take the rest of the day off.  The doctor was happy and surprised to hear that I haven't experienced many side effects.  He doesn't really have an explanation for it (when in doubt, blame it on hormones I guess), but said it's possible that somehow the pregnancy is helping to lessen the blow, so to speak.  As long as Sweet Potato is still growing and thriving, that's fine by me!

For the next two weeks, I returned to work.  This was my first venture visiting clients since I lost my hair.  As a behavior analyst, I work with people of all ages who have autism and other developmental disabilities.  I'll admit I was a little anxious to visit some of them, as they aren't used to seeing me look "different". I worried that a few might try to pull off my hat or even become aggressive because they have difficulty adapting to change and/or communicating their frustration.  But, it turned out that I had nothing to worry about and I was able to carry on, business as usual, without a single issue.  Here's a snippet of a conversation I recently had on one of my visits:

Client:  So how's that cancer goin'?
Me:  It's good, I'm taking special medicine to help me get better.
Client:  What kind of medicine? Is it free? Dont worry, I won't tell nobody.
Me:  It's medicine I get from my doctor.  No, its not free...
Client:  Well at least ya living and ya ain't dyin'!
(Touche).

On 9/25, I had a one-month follow up with my surgeon, Dr. A.  She checked my incision, which continues to heal just fine.  I also learned the results of my genetic testing:  negative.  In a nutshell, this means that I don't have any specific genetic markers that put me at higher-risk in the future for several types of cancer.  While this is generally good news, it doesn't really explain "why" I'm having to deal with my current diagnosis.  The doctor recommended talking to a genetic counselor to gain more understanding of the results, which will help me to decide what, if any, preventative measures I might take in the future.  But for now, those types of decisions are completely on the back burner.

I'm 7 months (29 weeks) pregnant now, and on 10/3 we had an appointment with the Maternal Fetal Medicine specialist to check on baby boy and see how he's progressing. Jeremy took a half-day from work, and my mother-in-law also came along for a sneak peek at her first grandchild!  We are SO happy to report that's he weighs over 3 lbs. now! That means he gained almost a full pound over the past three weeks.  Everything is looking perfect and he was kind enough to show us his face this time.  We can't wait to meet him in person :)

Other random news

I recently learned of a little something called "chemo brain."  Basically, it's a term used to describe feelings of forgetfulness, "spacing out," trouble concentrating, etc. that people experience during and after treatment.  As luck would have it, there's also something called "pregnancy brain" which involves the same type of symptoms.   Needless to say, I admit I feel like I've been losing a few brain cells recently!  

One day I poured a bowl of cereal, and immediately misplaced the milk cap.  Within seconds, I had absolutely no recollection of where I put it.  I checked the countertop, floor, trashcan, the silverware drawer, the fridge, my purse?  I improvised and covered the milk container with some plastic wrap.  That was over a week ago and still no clue where the cap went!  I find myself having to proofread emails and work documents more carefully, as my grammar seems to be getting a little sloppy.  I feel easily overwhelmed when trying to focus on tasks, like helping my husband with his graduate school course (he's training to become a behavior analyst, like myself).  I've also occasionally mispronounced words or said words out of order, and didn't notice unless someone pointed it out to me.  I'm sure these issues are short term but in the meantime at least I have some valid excuses!

My sister completed her 4th round of chemo on 9/23.  Treatments have hit her harder than me, because her meds are different.  The day after each chemo, she gets a Neulasta shot intended to boost her white blood cells.  The result is feeling like she has the flu, coupled with severe joint/bone pain, fatigue, mouth sores, and food tasting weird.  She's handling it like a champ, though, and has just TWO more treatments to go before she moves to the next phase!  Her husband (AKA my favorite brother-in-law!) is continuing to recover from open heart surgery and will be returning to work next week.  Let's hope the Steelers redeem themselves on Sunday, because surely it wasn't good for his heart to watch them lose last week (to the BUCS, of all teams!)

Third round of chemo is October 7th and I say BRING IT ON!

As always, thanks to everyone for keeping all of us in your thoughts and prayers.  xoxo