Friday, December 19, 2014

Baby's First Month (and Inductions are Dumb)

Here's a recap of Ben's birth story, for those interested.  I include a lot of details because perhaps there's someone reading this who's going through a similar situation and might want to know what the process is like.  However, I also realize that other readers (such as a random person from middle school who I haven't talked to in 15 years) might not be as interested in the details, so consider this my disclaimer and read at your own risk!  



I was scheduled for an induction on November 20th, exactly 1 month before my actual due date.  This date was selected by my treatment team as the optimal time where the baby would be developed enough to be delivered with minimal risks of complications, while also allowing me a brief recovery period so that I could get back on track with the next phase of chemo.  It had already been 3 weeks since my last chemo treatment, and my oncologist wanted me to start the next phase as soon as safely possible.  If I were to carry the baby full-term, too much time would elapse between chemo.  So, the induction date was set at about 35 weeks gestation.  We were told that it was a possibility, however, that Sweet Potato would have to go to the NICU for monitoring should any complications arise. 


A lot of people assume that a cancer diagnosis during pregnancy automatically means that you'll have to have a C-section.  However, this was not the case.  A C-section is considered major abdominal surgery, with various risks and a longer recovery time.  The biggest risk for me was infection, which would potentially delay the start of chemo.  If I were to have a natural delivery, I could start chemo within 1 week; for a C-section, I'd have to wait a minimum of 2 weeks, and possibly longer if there were any issues with the wound not healing properly.  Timing is everything.  My only fear was that I'd go through a long and drawn out induction, only to end up having a C-section...

So, on November 20th, Jeremy and I checked into the hospital at 5pm to start the induction process.  The plan was to begin with Cervadil, a medication intended to soften the cervix.  Before this could begin, however, I was hooked up to fetal heart-rate monitors to make sure Ben was cooperating.  Of course, he wasn't engaging in enough acrobatics to please my OB, so we were sent for yet another bio-physical profile (ultrasound).  And once again, he only passed 3 of the 4 criteria so the doctor switched to plan B.  Instead of starting with Cervadil, I began a low dose of Pitocin, an IV medication intended to jumpstart labor.  This was given to me overnight and I was encouraged to get some sleep (ha!)

The next morning, another bio-physical profile was conducted.  Jeremy and I are fairly certain that we could now qualify to work as ultrasound techs.  Beforehand, I was encouraged by the nurses to order the most sugary breakfast the hospital could provide, to ensure that Ben would wake the eff up for the test.  Toast+butter+jelly+yogurt+juice= success!  So, the nurses began increasing the Pitocin every 30 minutes or so.  Things were starting to get exciting and I finally began to feel some contractions!  My sister headed to the hospital to be my honorary photographer/labor encourager.  I told the rest of my family to sit tight, as I didn't want them all to make the trek to the hospital just to sit around and watch the clock. 

But alas, the Pitocin increases began to fizzle out, as they'll only continue increasing the dose based on how the contractions are progressing.  I forget exactly how they determine this, but for whatever reason, things were put on pause for a while and then completely turned off.  This was a weird feeling because as soon as they shut off the Pitocin, the contractions stopped.

Later that evening (about 24 hours into the induction), the doctor decided to revert back to the original plan and start the Cervadil.  This medication is inserted vaginally, which was not the most comfortable process as it took two nurses three attempts to get it right because apparently my cervix was hiding somewhere up near my intestines.  Hey, you were warned to read at your own risk but I assume we're all friends now.  Anyway, this med takes about 12 hours to take effect, so I was told once again to "get some sleep" and we'd check my progress in the morning.  I was then offered an Ambien, which I gladly accepted and finally got a decent night's rest.

The next morning, the nurse checked my progress and I was dilated (finally!) to about 1.5cm.  Not much, but the nurse seemed pleased and left the room to update my OB.  After a few minutes, however, she came back and said that the OB was hoping that I would've dilated more, and felt that it was time to move forward with a C-section.  She'd be on her way to the hospital in a few hours. 

Well, this was pretty much the one scenario that I was hoping to avoid: 40+ hours of being induced only to end up having surgery.  Every day counts, and I knew this would affect my chemo schedule.  But this baby's gotta get himself born somehow!

Phone calls were made to the family to head to the hospital and we visited for an hour or so before it was time to head to the OR.  Both of my OB's came in to talk briefly and I was relieved that they'd be working together.  If you recall, about halfway through my pregnancy and right when I got the cancer diagnosis, a new OB joined the practice and I was bummed that I basically got handed over to her, instead of the original OB whom I really like.  Jeremy was instructed to don a full-on spacesuit and mask and we walked together down the hall.  He was then told to wait outside with one of the nurses while I headed in to get prepped.  What a weird feeling to walk yourself into an operating room!  The room was freezing cold and 80's music was playing which was oddly comforting.  I immediately began shaking uncontrollably, mostly due to nerves and the start of apparent hypothermia (I never get cold!).  I was told that the spinal epidural will also cause the shakes, so my arms and teeth continued to chatter nonstop throughout the entire procedure.

The anesthesiologist sat directly to my right and talked me through each step of what was happening.  Once I got settled into place, a giant curtain was placed in front of me to block the action, and Jeremy was seated to my left.  Then both of my OB's came in and got right to work.  It was very much an out-of-body experience as I could hear them casually talking about Black Friday shopping while they cut me open.  Though I didn't feel any pain, there was slight pressure when they actually took the baby out.  They held him up so we could see him briefly and he let out some very healthy cries!   Music to our ears :)




The nurse called Jeremy over while Ben got inspected and I craned my neck to watch.  The nurse said that Jeremy could touch him, and I watched from afar as he gingerly held out his finger and Ben grabbed it right away.   I know, I know, it's a basic grasp reflex, but...swoon!   Jeremy cut the cord (which he hadn't planned on doing, so props to him for making a game time decision!) and before we knew it, I was stitched up and ready to be wheeled out. They placed Ben in my arms and off we went to the postpartum room.  No need for the NICU!

The next few days were a whirlwind of visitors and various nurses and staff coming in and out of the room at all hours.  All. Hours.  The pediatrician on call (who works in the same practice where we'll be taking Ben) checked on us every day, and was extremely caring.  He even put me in touch with a local mother who was also diagnosed with breast cancer during her pregnancy and now has a healthy 1-year-old.   She actually called me while I was still in the hospital, so we chatted for a bit and exchanged contact information.  Our situation was a bit unusual for a lot of the nursing staff, and at times nurses stopped in just to say hello who didn't even work with us directly.  Some nurses from the L&D unit came over when their shifts ended to check on us.  I can't say enough about how awesome all of the nurses and techs were.  

Recovery from a c-section is no joke.  I felt fine at first, but once the meds began to wear off, I learned that it's really hard to try getting in and out of bed without using any abdominal muscles!  I was stubborn about taking additional pain meds, but the nurses eventually sold me on the wonders of Percocet and I'm glad I finally listened to them.  

Ben was born on a Thursday, and by Friday evening my OB gave me the go-ahead to be discharged on Saturday morning.  I was excited to go home, but also apprehensive because I definitely wasn't feeling 100% and worried about how I'd get in and out of bed at home, not to mention up and down the stairs (we live in a townhouse).  The on-call pediatrician, a very grandfatherly-type, came to check on Ben Friday afternoon, and was surprised that I was being sent home so soon.  He suggested that we stay an extra night and take advantage of the nurse's help.  Deep down I knew that he was right, so we took his advice and extended our stay by another 24 hours.

Time has flown since bringing Ben home.  Tomorrow is his actual due date and he'll already be one month old!  It's been quite an adjustment, but we've had so much help from family and friends to make the transition easier.  I'm sure a lot of people wonder whether I'm able to breastfeed and the answer is no.  My milk never came in and since I'll be getting chemo for the next 3 months, it wouldn't be safe for consumption anyway.  I'm a little sad that I wasn't at least able to try, but in the grand scheme of things I'm just happy that Ben is here and in one piece and he is perfect.  And he wasn't born bald, or radioactive, or with 3 eyes like some people may have secretly worried ;)


Napping in the family cradle, which has been passed around our family since 1967.
First visit to the pediatrician.
First bath (nailed it).
Baby burrito!
First Thanksgiving, 1 week old.
Our sweet little doll.
Brotherly Love
Getting Back on the Chemo Train

On December 9th, I started chemo again, and will be going every Tuesday for 12 consecutive weeks (as of this writing, I've already completed 2 rounds, yay!).  The new drug is Paclitaxel, AKA Taxol.   Possible side effects include: neuropathy (numbness/tingling) in hands and feet that gets progressively worse with each treatment, mouth sores, acid reflux, fatigue, nausea/vomiting, hair loss, joint/muscle pain, low blood count, and loosening of the nailbeds.  Fun stuff!

Before Taxol is administered, I have labs drawn to make sure my blood counts are good. Then, a series of "pre-chemo" drugs are given through the IV, to counteract some of the side effects.  So, my current line-up includes: Benadryl (to prevent allergic reaction), steroids to keep my immune system afloat, Pepcid (for acid reflux/indigestion), and Zofran (for nausea).  The entire process takes about 4 hours from start to finish.  

In a weird way, I'm happy to finally be getting chemo again (or as I now call it, my "day at the spa"), after about a 6-week break. Going that long without actively doing anything to address the cancer was starting to make me nervous.  Now that Ben is here and healthy, I want to bring out the big guns and do everything I can to fight this!  

I'm in a Facebook group for women facing cancer during pregnancy, and while it's an awesome support network with some really incredible women, it's also served as a reminder of the truly awful realities that other families have gone through.  There are women, young women, who have passed away within a few months of having their children because their cancer had spread and nothing else could be done.  It was just too late.  It is absolutely heartbreaking and my mind can't help but wander to places where I don't want it to go. And because I've yet to have any scans to determine whether the cancer has spread, there are a lot of unknowns.  So for now, I just have to trust that my doctors have set me up on a treatment plan that's working, and that there's a light at the end of this shitty tunnel.  Not going to lie, though, it's tiring and sometimes I wish I could just take a time-out for a few minutes and feel "normal" again.


Our Wedding, December 2007.
Chemo "lunch date" on our 7th anniversary=not normal.
Appreciation

Since being diagnosed in July, there have been so many people who've helped us in ways big and small.  Family, friends, neighbors, co-workers, complete strangers.  We've had meals delivered on nights when the last thing I wanted to do is cook dinner, let alone go grocery shopping.  We've been able to have our house cleaned every month, thanks to Jeremy's co-workers pooling their money together (and it's no secret that teachers don't typically have a lot of excess money to pool).  We're lucky to have family members that live a few minutes away that can watch Ben every week while I'm at chemo.  I'm lucky that somehow one year ago I had the foresight to purchase a good insurance plan.  My monthly premium ain't cheap, but boy I've made good use out of it this year.  

It's astonishing how quickly people are willing to jump in and do whatever they can to give us one less thing to worry about.  It's something I give thanks for every day.  At times, Jeremy and I will just look at each other and not even know what to say because we're both so speechless that people can be so incredibly generous.  Case-in-point:  this morning we opened our front door to see a jar full of money with a card attached.  It was left by an anonymous family who wrote that each year they teach their children to save up their spare change, to give to someone in need at the end of the year.  This year, they chose to give it to us.  To that family:  I don't know if you read this blog, but if you do...thank you.  

My sister has a lot to be thankful for as well.  She completed her chemo regimen and recently had surgery to remove her tumor.  Surgery was a success and the margins were clear with no evidence that the cancer spread to her lymph nodes.  Next, she'll be having radiation, and her doctor is very optimistic that she's on the road to remission.  Fingers crossed that this good news continues for her!

Thanks to everyone who takes the time to read this.  And thank you for the continued support and prayers.  


2 comments:

  1. Congratulations Dee It was wonderful to see the three of you. You are always in our prayers. XoXo

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    Replies
    1. Great to see all of you as well! And Ben loves all of his new things with his name on them :)

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