Tag Archives: high risk pregnancy

Four Down and Baby Comes Next!

I had my fourth chemo treatment on February 8th. This is my last chemo treatment before delivering! After I deliver, I will then complete 2 more chemo treatments. There are a lot of changes coming up for my family and I.

Treatment #4

Things went pretty smoothly for my fourth treatment. I had no immediate side effects from the chemo and I felt like back to ‘normal’ after I left the hospital. In a way, each treatment is kind of unknown how I’ll be. Maybe I’ll be tired, maybe not. So far I’ve made it this far with only a handful of days feeling fatigued, so I’m grateful for this success. You really wouldn’t know I had cancer if it wasn’t for my bald head!

I think what I hate the most about chemo treatment is getting poked with the huge IV needles. Even though I’ve done it a bunch of times, I still cringe at the thought of it each time the needle goes in. This really isn’t much to be upset about in the grand scheme of things.

Here Comes Baby

As of now, the plan is to deliver the baby at 36 weeks, on or around the week of March 4th. It’s hard to believe we only have a couple more weeks as a family of three. Once the new baby is here, our family dynamics and routines will definitely change. I’m certain I’ve totally forgotten how to take care of a newborn and I’ll have to figure it out all over again. I’m currently in full on nesting mode and making Roberto move furniture and get things out of storage.

I’m hoping I’ll be able to maintain my same energy level I’ve had throughout my cancer treatment and I won’t be hit with fatigue or other side effects with the upcoming chemo treatments. My doctor is considering changing my chemotherapy regimen after I deliver (from R-CHOP to R-EPOCH). This is the preferred regimen for my diagnosis and is more intense. It wasn’t an option for me to do while I was pregnant. I’ll find out once I do a PET scan after I deliver.

The CDC recommends for expecting mothers to get the Tdap vaccine during the third trimester of each pregnancy to help protect the against whooping cough. The mother is able to pass on the antibodies to the baby. I wasn’t sure if the Tdap was okay for me to get because I’m immunocompromised. I learned that the Tdap can be given to cancer patients, but wasn’t sure about pregnant cancer patients, if it made a difference. After consulting with my doctors, I learned that there isn’t enough research out there to show that the Tdap will act the same way for me and pass antibodies on to the baby like it would for a healthy pregnant mother. However, they said getting the Tdap wouldn’t hurt me. So I decided to move forward and get the Tdap in hopes it will benefit the baby.

Unexpected News

My doctor gave me some unexpected news that I will likely need radiation after the 6 chemo cycles are done. I don’t view this as a bad thing, but yes, it does make my cancer “to do” list longer. I’m hoping the radiation can all be done while I’m on maternity leave. Although I heard radiation can be painful and leave you fatigued, I am looking forward to not dealing with chemo side effects anymore. Hopefully, my hair can start to grow back and I won’t have to worry so much about a weakened immune system.

Cold & Flu Season

Everyone knows how bad the flu is this year. This is the worst time of year when it comes to getting sick. I’m continuing to have to be extra cautious not to get sick from being around people or touching things in public. I wash or use hand sanitizer on my hands probably well over 20 times a day. I wear a face mask when around people. I don’t know if I’m being super paranoid, but I can’t risk getting sick with a weakened immune system. I can’t wait for the cold and flu season to be over already! And as a PSA: please wash you hands, cover your cough, and stay home if you feel sick symptoms!

Ongoing Support

My coworkers extended my meal train so we have food through the month of March. I’m so grateful for this because it makes things way less stressful each day when we’re done with work and don’t have to worry about cooking or meal planning.

I’ve also gotten so many supportive cards from people, ranging from friends, family, acquaintances, to even total strangers. It’s very kind of people to think of me during this time and I’m still so humbled by all the support. Here’s a giant card my family made me:

My next update will be as a mama of two! Stay tuned for the much anticipated announcement of baby boy’s birth! He’s estimated to be about 6 lbs when I deliver at 36 weeks so he will he will be a decent size!

Ending 2017 with Chemo Round #2 and Looking Forward to 2018

2017 is over and I can happily say that we are now 1/3 done with my chemo treatments. Celebrating small milestones is really what is getting me through this long journey.

For my second treatment, my doctor wanted to have it done inpatient one more time to monitor me. I was admitted on December 27th in the early evening and fortunately this time things went much faster and the entire chemo treatment was able to be done in less than 24 hours.

Sherrie came to the hospital to keep me company while I waited to be admitted. We chatted about babies, life, and other random stuff  it was nice to just socialize face-to-face because I’m not able to get out as much now.

Chemo Time

I got a room at 6:30pm and had to wait for all the chemo orders to be put in before we could start. This time, they started with the rituxan (the R in R-CHOP) first at 11:30pm. This is the drug that has the most side effects and also takes the longest to administer. Last time, the doctor wanted to be conservative and minimize side effects so it was administered very slowly where it took 13 hours. This time, the speed was increased slightly so it was done over 8 hours overnight. I had a different reaction this time. I felt like I was covered in ants crawling all over me and was very fidgety. I had to have Roberto put an ice pack on me or rub my back because I felt so weird. I asked the nurse for Claritin and this ended up helping me and I was able to get some sleep. The rituxan ran until 7am and they have to check my vital signs every hour! So I didn’t get great sleep that night. That’s okay though because I rather get things done faster and go home sooner.

The next morning, I received the rest of the chemo drugs (the CHOP portion in R-CHOP). Like last time, I had no reaction to these drugs. We were done with all of them by noon! We ate lunch and waited to be discharged. I didn’t need a blood transfusion this time because my hemoglobin counts were fine. Side note: MD Anderson is in need of blood donations.

I was discharged by 2:30pm and we headed home. Since the chemo treatment, I’ve felt pretty good. Over the next 3 weeks until the next chemo treatment, the doctors will continue to monitor my blood counts. Last chemo cycle, I did become neutropenic (low white blood cell count) and did have to get an injection (Neupogen) that stimulates white blood cell growth in my bone marrow. While I am neutropenic, my immune system is especially weakened and I have a higher  risk of infection occurring so I have to be extra cautious. It’s expected that this  will likely happen every chemo cycle. My next treatment is January 18 and will be done outpatient this time.

Here I am working on my team’s year-end performance reviews the last week of the year while getting my chemo infusion.

Notable Progress From This Round

  • Normalized blood pressure. Prior to this my blood pressure was low (like 100/60) and now it’s closer to the normal range of 120/80.
  • Lowered heart rate. My heart was working hard to pump blood with the mass in the way, so my heart rate was around the 90s at rest (previous to this I had a resting heart rate in the 50s!). It’s now down to the mid-70s to 80s.
  • Increased lung capacity. My spirometer readings continue to improve!
  • Not really progress, but something notable. More hair loss. Yes, it is upsetting, but the chemo is working. I’m glad I cut my hair.
  • Baby continues to grow and is healthy. Last ultrasound he was at 73 percentile in growth! I am currently 27 weeks–third trimester here we come!
  • Increased energy levels. I’m walking more with my longest walk up to 45 minutes. I’ve also added in light resistance training 3x a week to maintain muscle tone and strength.
  • Because of my increased energy levels and Camila has been healthy, I’m able to spend more time with her.

Ringing in 2018

I was still able to have a little fun ringing in 2018. I’ve been feeling conflicted whether to go out (and risk getting sick with this crazy flu season) or stay in. I went to my aunt and uncle’s house to have a little New Year’s celebration with my family (and when you have kids you celebrate it at 8pm anyway).

As I reflect back on 2017, it really was a great year for me despite my diagnosis. We traveled to Scottsdale, Sedona, Clearwater, and Austin. We had all of Roberto’s family come visit us and Camila got to meet her first cousins for the first time. We’re expecting a baby boy! I continue to enjoy my job. We survived Harvey with minimal issues. Camila is healthy, thriving, and happy. My love for Roberto has grown stronger. I’ve been filled with so many blessings in my life that even despite my diagnosis, I still feel incredibly fortunate.

I’m pumped for an even better 2018 filled with more love, memories, adventures, another baby, and kicking cancer’s ass. Happy new year to you and here’s to a great 2018 ahead!

Chemo Treatment #1 – DONE!

I have 6 chemo treatments total and I’m proud to say that the first treatment is completed and went very well! I already feel a significant improvement in my symptoms. Normally, the chemo treatment I’m prescribed (R-CHOP) is done outpatient and in a day, but due to my pregnancy, my doctor wanted my first two treatments to be inpatient and administered slowly so they could better monitor me and limit any adverse side effects.

Prior being admitted for my first treatment, both Roberto and I felt incredibly pumped to start. I was tired of feeling like crap all the time and ready to start feeling better! My doctors had said that even after the first treatment, I’d start to notice a difference. I didn’t care if chemo was going to possibly have bad side effects, I was weirdly excited about feeling better.

Before every treatment, I meet with my high risk obstetrician and she checks the baby through ultrasound to make sure everything is going well. She signs off that the baby and I are ready to go through chemo. The R-CHOP chemo regimen has been used on pregnant patients in the past and the outcomes have been positive.

Chemo – Day 1

I was pretty ignorant about cancer before my diagnosis. Admittedly, I didn’t even know chemotherapy was administered through IV. I have a tremendous amount of respect for anyone in the medical field and especially the staff at MD Anderson who openly educated me over the last few weeks. I’ve learned a lot!

I was admitted for treatment on December 4th, less than a week after my diagnosis because I needed to start immediately. Aside from when I had Camila, this was my first time staying in a hospital. And for anyone who has stayed in a hospital, you know that a lot of it is waiting. By no means am I saying the hospital is inefficient, but there’s lots of checks and due diligence required before they can start giving you drugs. Because I have so much downtime, I’ve been able to continue working during my treatment

Roberto and Maggie (my best friend, who is conveniently also a clinical pharmacist at MD Anderson) stayed with me throughout my chemo treatment. I really couldn’t have been in better hands! Having them there really made me feel more at ease.

My chemo treatment, called R-CHOP, was started in the evening around dinner time. They gave me the CHOP portion of it. The C, H, and O were administered over IV and took about 3 hours total. The P was prednisone, a steroid pill that I take daily for 5 days. They gave it to me at night, so I was super hyper that evening. Roberto said he had never seen me so chatty at night in a long time, because lately I’ve been so exhausted.

We were done with the CHOP portion by bedtime and immediately that evening I already noticed my symptoms subsiding. I was coughing much less and way less itchy. Maggie said that this is probably from the immediate effects of the prednisone, but this was really exciting to see I was already feeling better! I didn’t fall asleep until 2am because of the prednisone side effects.

Chemo – Day 2

The next day, I was going to be administered the R portion (rituximab), which is the largest dose of chemo and most likely to have side effects. The doctor wanted to administer it very slowly to minimize my side effects… so slow that it was going to take over 13 hours to do it. We started around 11am and it completely finished at almost 2am! The only adverse side effect I had was a brief period of feeling lightheaded and low blood pressure at the very beginning. It’s very possible it was caused by the Benadryl they gave me though, to help with the possible itchy skin side effect. Overall, it wasn’t too bad as I expected it to be. I was still able to get up and walk around with my IV while it was being administered.

I was fortunate to have several people come visit me at the hospital that day to keep me entertained during the long infusion. My cousins Brian and Julie, aunt Thu, and friends Alice and Jeff came by to keep me company.

My symptoms continued to improve that evening. It was really motivating to see such immediate results. Also, I started to finally have more of an appetite and eat like a pregnant woman. The hospital food at MD Anderson is actually pretty decent and the portions are huge! I was laughing with the nurses because the fried shrimp platter contains 8 pieces of shrimp, each the size of a baby’s fist. What other restaurant serves that much shrimp and that big?!

Day 3 – Ready to Go Home

By the third day, I was ready to be discharged because we were done with treatment and I had no adverse reactions that required additional monitoring. However, I needed a blood transfusion to increase my hemoglobin count before going home. This is a pretty simple procedure with minimal risk. (Side note: thanks to anyone who has ever donated blood in the past!) Being pregnant, doctors wanted me to have sufficient hemoglobin so enough oxygen could be carried in my blood to the baby. I had to get two blood transfusions that day which took over 7 hours to do. I was finally discharged at 9:30pm that night and it felt so good to be home!

A New Routine

As soon as I got home, I realized my home life was not going to be the same. I had to focus on my health. That meant making sure I didn’t get sick because my weakened immune system may not be strong enough to fight it. Inconveniently, Camila had a cold this week so I had to stay away from her.

There are a lot of things I have to avoid doing now to prevent getting sick or infections. This includes not going to crowded, public places, working from home, washing my hands constantly (they are so dry now), wearing a face mask, not doing certain household chores, avoiding raw fruits/veggies, and the hardest of them all, relying on others to care for my child. Since Camila goes to daycare, it’s potentially exposing me to a whole lot of germs. And it’s cold and flu season. For now, Roberto and my parents are the one helping take care of her (as well as many other things around the house) while I sit wearing a face mask. I know she’s in good hands with them, but it’s hard to sit back and not be mom. (More on this topic in a future post.)

All these things are temporary though. Eventually, my life will be back to normal and I realize this is a temporary sacrifice for my overall health.

Until the Next Chemo Treatment

I have three weeks between chemo treatments. I’m still working during this time (willingly and happily, as I enjoy my job and my employer has been very understanding). I’m able to work from home. It helps me feel safer since I’m less likely to get sick, and I also feel productive and engaged everyday.

My priorities each day are to get lots of rest and sleep, drink lots of water, and exercise/walk. So far, I’ve been feeling great. My energy levels have been pretty good. The doctor is happy with my progress. To reduce daily stress, we’ve outsourced some of our household chores. Several gracious friends and family members have provided food for us and that has taken the relief off from cooking.  I’ve even succumbed to using the <gasp> dishwasher daily!

My symptoms have dramatically improved just after one treatment. I went in with a terrible cough caused by the mass in my chest. The mass was so large that I couldn’t even lay in a reclined position without coughing uncontrollably and feeling like I was suffocating. The cough is nearly gone now! I can finally lay in reclined positions comfortably (my back is so happy). I no longer get winded from walking up a flight of stairs! My fractured rib is nearly completely healed. I still have itchy skin and unfortunately this keeps me up at night at times, but I’m optimistic it’ll improve with the next treatment.

All the Support

I want to thank everyone for the outpouring of support. Whether this is praying for me, texting to see how I’m doing, sending food, helping with Camila, or just sending positive vibes, please know all of this is helping me!

I know a lot of people feel sad when they hear my situation, but please don’t feel this way. Instead, find comfort and hope knowing that my treatment is going well and I feel so much better.

Notable Progress From This Round

  • Coughing is almost completely gone!
  • No longer winded from walking up a flight up stairs. I even went on a 30 minute walk and started doing light resistance training at home.
  • Huge appetite increase – finally eating like a pregnant woman and having cravings!
  • Increased lung capacity – spirometer (breathing tool) readings have gone up 500 mL since I left the hospital.
  • Improved energy level – I have more energy now than before. There are some days I am fatigued, but it is completely manageable.
  • As of the publish date of this post, I still have my hair and have not yet noticed any hair loss. I’m crossing my fingers those prenatal vitamins pull through, but I know it’s a long shot.
  • I had an MRI after the first chemo treatment to check if the cancer ever spread to my pelvic and abdominal and it did not! So this means I do not have stage 3 or 4 lymphoma, likely stage 1 or 2.
  • Most importantly, baby is healthy and growing at the right pace. As of the date of this post, I’m 25 weeks pregnant.

Next chemo treatment is December 27th. I’m ready! I’ll be 1/3 done by the end of 2017!

How It All Started

It all started as a little cough. It wasn’t too bad so I didn’t think too much of it and procrastinated seeing the doctor about it. More than 2 months later, the small “tickle of the throat” cough turned into a stronger, spastic cough. I was 14 weeks pregnant at this point and the cough was now disruptive to my everyday comfort. I also noticed I started having some shortness of breath, fatigue, and itchy skin but figured it was due to the pregnancy. I did find the shortness of breath unusual since I was still regularly working out and teaching fitness classes.

Disclaimer: if you don’t want a TL;DR version, you can stop here and know it all started with a cough. If you want the full version, keep reading!

Over the course of the next 6 weeks, doctors tried to treat my cough as asthma, allergies and a sinus infection, with the limitations of medications available to a pregnant person. Nothing improved. Every doctor I visited listened to my lungs through their stethoscope and said my lungs sounded clear. I had been through inhalers, tons of different allergy medications, and three rounds of antibiotics. My cough continues to be powerful, riveting my whole body to the point where I fractured a rib. I tried to be patient with each of the different treatments we tried, eagerly hoping one of them was “the one” to solve my cough. I also started getting winded just walking up a flight of stairs. This was unusual for someone who regularly worked out, I thought.

Nothing worked. My symptoms got worse and my body was in pain from constantly coughing.

When Benefits Outweigh the Risks

Finally, one of my doctors said we were at the point that we needed a chest X-ray if we wanted to find out more. I hesitated. X-ray? Pregnant women aren’t supposed to get X-rays, I thought. It’s just not safe! I consulted with my obstetrician and he said at 20 weeks pregnant, it was okay as long as they shielded my abdominal region. I moved forward with getting my X-ray.

Within an hour, I got a call from my doctor with results. He said there was some sort of large mass around my left chest. It could possibly be pneumonia or a tumor, but he couldn’t confirm from the X-ray, but there was definitely something abnormal. Both of these possible results sounded awful. He told me to come in the next morning ASAP to further discuss with my regular PCP (the doctor that got the results was my PCP’s backup since she was out that day). I remember hoping it would be pneumonia because I thought that would be much more treatable than a tumor.

My doctor explained that she needed a CT scan to be able to tell what the large mass in the X-ray is. CT scans have incrementally more radiation than an X-ray. Is this safe for the baby? As a mom, we constantly have the mental battle between sacrificing ourselves for the sake of our child. My doctor consulted with my obstetrician and he said that a CT scan would be okay as long as they took extra precautions such as shielding my abdominal region and minimizing contrast used. He also explained to me that based on my X-ray results, we were at a point where we needed to weigh the risk vs. benefit of what I potentially had. In order for the baby to be healthy, I needed to be healthy.

The C Word

My CT scan was scheduled the following morning. Within two hours of doing my CT scan, my doctor had the results and called me. I remember being at work and having to find a quiet place to sit down to talk to her. She explained it was a 14cm mass sitting on top of my left lung, pressing against some of my vital airways and blood vessels. This was why I was coughing and having shortness of breath. She wanted me to meet an oncologist with MD Anderson ASAP because a biopsy of the mass was needed to determine if it was cancerous. Cancer. That word alone is scary.

Thanks to my doctor’s quick action and sense of urgency, I was able to see an oncologist at MD Anderson in the next three hours. Due to my pregnancy, my situation was prioritized.

My world was spinning at this point. In less than 48 hours, I went from thinking I had a sinus infection to possibly having cancer. We met with the general oncologist at the MD Anderson Sugar Land location. She explained that the “ideal” situation would be that the mass could be lymphoma, which is very treatable with chemotherapy, even during pregnancy. If the mass was actually benign, surgery would actually be more complicated to remove it due to its close proximity to my heart and other major blood vessels.

I wasn’t sure what to think of those possibilities presented to me. Both sounded awful. The next necessary steps were for me to get a biopsy of the mass to confirm if it was cancerous. The oncologist and radiologist had to evaluate how to do this biopsy. There are noninvasive, efficient ways to do a biopsy, but they involve radiation. These weren’t an option for me due to my pregnancy. The radiologist said he could instead do a biopsy using an ultrasound and find a place to extract the mass tissue. This is usually done under general anesthesia, but because of my pregnancy I opted to do it under local anesthesia to reduce more drug exposure to the baby. I remember feeling extremely nervous about the biopsy. Was it going to hurt? Could I tolerate the pain?

The biopsy was done a few days later, the week of Thanksgiving. They used lidocaine to numb my chest area and got to work on the biopsy. It was painful, even with the lidocaine. Due to the mass, I have a hard time laying flat without coughing compulsively. This, coupled with the biopsy pain and discomfort, was hard. It was finally over and I felt a sense of relief. One obstacle down, but there were many more to come.

And We Wait

I tried to enjoy Thanksgiving as much as I could. It was hard to lie to well-meaning relatives asking me if I was okay and why I was still coughing so much. I told them it was allergies to try not to worry them.

While I waited for the biopsy results, there was a lot of praying and reflection. Deep down, my intuition told me that I thought I had cancer. Roberto and I prayed it could be something else that was treatable. But for some reason I had the lingering thought that it was cancer.

An Answer and a Plan

A week after the biopsy, at 22 weeks pregnant, I got a call from my oncologist on the results. She confirmed it was lymphoma. Specifically, I had a non-Hodgkin Lymphoma called primary mediastinal large B-cell lymphoma. She explained to me that getting chemotherapy treatment pretty soon was necessary due to the size of the mass. She didn’t know the stage of the cancer, as this requires additional tests like a PET scan and bone marrow biopsy. Due to my high risk situation with my pregnancy, she wanted me to be seen soon by a lymphoma specialist at the MD Anderson main campus for a consultation.

I was at work and in shock. I didn’t know what to do. I called my mom and told her the sad news. My mom was devastated. She told me she wished it was her instead of me having to go through this. I remember my dad calling me shortly after to tell me that my mom had told him the news. He told me he had no words, except that he was here for me. I held back my tears. Roberto and I left work early to absorb the news privately.

I am eternally grateful for all of my medical team who treated my situation with such urgency. It is thanks to them that I received immediate, customized medical care. There are many people who cannot even get admitted to be seen at MD Anderson, the #1 cancer treatment center in the country, and I had an appointment within hours. I was able to see the lymphoma specialist the next day. This day happened to be our fourth wedding anniversary.

My obstetrician called me and said he learned the news from my general oncologist. He recommended I look into maternal fetal medicine specialist who was experienced with high risk pregnancies. But because my case was so rare, he didn’t know any that were experienced with cancer patients.

We met with the lymphoma oncologist who I later learned treated the most pregnant lymphoma patients in the practice. I felt I was in the right hands. She immediately got down to business and explained to us what chemotherapy treatment I needed and that I needed to start it the following week. I was blown away. In 5 days, I needed to start chemotherapy?! She explained the mass was so large and pressing against major airways and blood vessels that we couldn’t afford to wait.

The chemotherapy treatment recommended for me is R-CHOP, which is safer for pregnancy than other chemo treatments that are used for my same diagnosis. I would have six chemo treatments, once every 3 weeks. This amounted to about 18 weeks of chemo, which ironically was the same amount of weeks left in my pregnancy.

The lymphoma oncologist also recommended a maternal fetal medicine specialist that was experienced with cancer patients. They would work together to ensure each chemo treatment is going well for me and baby. After later meeting with the maternal fetal medicine specialist, she explained that our goal was to have four chemo treatments, wait three weeks, deliver at about 35-36 weeks pregnant, and then finish my last two chemo treatments.

Being the planner I am, I felt relieved we had a plan now to start my treatment. Seeing the chemo and pregnancy plan in small increments made it feel achievable and less intimidating.

What’s Ahead

So that’s my story of how it all started. The road ahead is scary and full of unknowns. But what I do know is I choose to be strong because being anything else at this time is not a choice for me and my baby.