Tag Archives: pregnancy

Happy Birthday, Joel!

One of our biggest anticipations has been the hope and prayers that baby boy would be healthy despite all the treatment I’m going through. After four rounds of chemo with me, Joel Lucas Moreno came into the world on March 6, 2018 at 8:04am! He weighed 6 lbs 13 oz and was 19” long. Most importantly, he’s healthy!

Skin to skin with mommy after delivery

Labor & Delivery

Disclaimer: For those that like to know the details of labor and delivery, read on. For those that don’t care for it, you can skip this section!

I was scheduled to be induced at 36 weeks. It was important to my OB that I was at least 3 weeks out from my last chemo treatment so my white blood cell counts had enough time to recover, but also she wanted me at least 36 weeks to allow the baby to develop more. I also couldn’t be too full term as there is already a risk of me delivering early. So we scheduled my delivery at 36 weeks and 2 days. The plan is to have a vaginal birth, as this has a decreased risk of infection and quicker recovery time.

The induction plan meant being admitted to the hospital the night before and starting the induction process to deliver the next day. Three days before induction, I was already 1cm dilated. I went for some walks that weekend hoping it would help naturally prepare my body more for labor. When I got admitted to the hospital, I was 2-3cm dilated and 60% effaced so it helped some.

They started me on pitocin at 12:30am. It was going to be nearly impossible for me to get any sleep if contractions were going to eventually start, so I asked for Ambien. It didn’t really help because as soon as I’d doze off, a contraction would wake me up. I asked for some IV pain meds which helped for a bit, but by 3:30am I was ready for the epidural since the pain became too much for me. I got the epidural at 4am and immediately after it, I laid back down and my water broke! The nurse said it was good timing. At this point, I was 5cm dilated so the nurse said things could now progress pretty fast. I was able to get some sleep thanks to the magical powers of the epidural.

Around 6:30am I woke up and started to feel pressure when a contraction came. I told the nurse and she checked me—I was now 10cm dilated! The baby was ready to go! They called my doctor who had to come in during Houston morning rush hour. The contractions had pressure but I didn’t feel a strong urge to push yet, so I was able to wait for my doctor to arrive. After 3 quick pushes, Joel came into the world at 8:04am!

He’s Finally Here

Anyone who has become a parent has probably experienced the unbelievably surreal feeling of your baby coming into the world. Roberto and I have been waiting for Joel since the moment we knew we were expecting—and that anticipation exponentially increased when we initially thought he had Down syndrome and again when I was diagnosed with cancer. Hearing his first cry and seeing him for the first time was an overwhelming moment of relief and happiness I will never forget.

After being reviewed by the neonatologist and multiple pediatricians and taking several tests, Joel is healthy. He passed his glucose tests, bilirubin test, and hearing test. His CBC blood counts are in a normal range. He’s eating well, pooping, peeing, and sleeping a ton—all the things you want a baby to do! We really feel that everyone’s thoughts and prayers for us and Joel have been answered. There is a chance his B cell counts are low due to my diagnosis, but it will catch up by the time he is 6 months old. Until then, we have to be extra careful he does not get sick.

A New Life

After two night at the hospital, we were discharged. We came home and are adjusting to our new life as a family of four (five if you count Luna). Not only am I trying to figure out balancing being a mom of two, but in a few days I’ll resume and eventually complete my cancer treatment.

Now that I’m not pregnant, my doctors will really be able to treat me. This means I can finally have a PET scan to determine what cancer cells remain and what treatment changes should be made, if any. Roberto said that the rest of this journey is all about me now. We now know that Joel is healthy. Now the focus is on me completing my treatment so I can be in remission. We dream of the day where the four of us can finally go somewhere together as a family. It’s not too far away.

Through this, my mom is helping us a ton with Joel and Camila. It’s helped me get extra rest time and also allows us to give Camila attention. Thank goodness for grandmas!

About Joel

Joel isn’t even a week old yet, but so far he’s a pretty easy baby. He’s eating well, sleeping a ton, and laid back. He cries only when he is cold and during diaper changes. He’s trying to establish himself as the man of the house because he’s peed on Roberto probably once a day, but hasn’t yet peed on me (knocking on wood).

What’s in a name? Joel is also Roberto’s middle name. His middle name, Lucas, means light or illumination. We picked it because he is the light to this otherwise dark journey we’re going through.

Someone More in Need

Shortly after I was diagnosed, I learned I was not going to be able to breastfeed as the chemotherapy drugs could pass on to Joel through my breastmilk (when he was in my womb, we had the placenta to help filter it). Although I’m not against formula feeding, this was probably the most disappointing part of being diagnosed. I breastfed Camila until she turned one and felt she has reaped the benefits of breastfeeding. I wanted Joel to have the same benefits. I accepted early on that Joel would be formula fed.

I did hope that we could possibly get donor breastmilk for Joel so at least he could get some breastmilk. Because of Joel’s possible low B cell count, we couldn’t accept just any donated milk. Donor milk from a milk bank was pasteurized and screened. I learned I could ask for donor milk while still in the hospital after delivery. However, I also learned I was not going to be able to get insurance to cover donor milk once we got home. After talking to pediatricians and a milk bank, I learned that I wouldn’t qualify for donor milk because Joel was able to have formula. If I wanted donor milk, I could pay for it out of pocket which could cost thousands of dollars a month.

My initial reaction was how unfair this was. I thought I had a good case of needing donor milk. I thought to myself, “I can’t give this to my child, why can’t they help me?” The milk bank informed me because the need for donor milk was because of the mother and not because of the baby. If the mother is unable to breastfeed, but the baby can have formula, insurance wasn’t going to approve it. Insurance would only approve it if the baby had a sole need for breastmilk.

It opened my eyes to a realization. There was someone out there that needs the donor milk more than Joel and I do. I have a healthy baby that is able to have formula. There are babies out there with health issues that are unable to have formula and their moms are unable to produce breastmilk. They need the donor milk more. No matter how bad of a situation you think you’re in, there’s someone else out there going through something harder that’s more in need than you.

Happy Birthday, Joel. Please know that your dad and I are amazed by your strength and will do anything for you.

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!

Before Cancer… We Had Another Scare

Before my cancer diagnosis, Roberto and I went through another scare related to this pregnancy. We had a non-invasive pregnancy test (NIPT) that came back with a positive result for Down syndrome. We have now learned that this result was actually related to my cancer diagnosis. I am sharing this experience in hopes that it helps other families affected, as there is minimal information out there linking cancer and NIPT results.

Disclaimer: no personal beliefs regarding Down syndrome or pregnancy termination are expressed in this post.

Yay! We’re Pregnant!

I was very fortunate to have a healthy pregnancy with Camila. I taught group exercise classes, lifted weights, and did Zumba until I was 38 weeks pregnant! I had no pregnancy issues. I figured since I was still in pretty good health and fitness and delivered a healthy baby, my second pregnancy should be smooth too. I was hoping to be active through my pregnancy to have a strong body ready for labor and delivery. Surely these things would lead to a healthy baby.

I went ahead and scheduled my prenatal care for the first trimester. We had two ultrasounds done and both looked good. We elected to do optional first trimester genetic screening testing, known as Non-Invasive Prenatal Test (NIPT). For those unfamiliar with this test, it screens if there is missing or extra chromosomes 13, 18, 21, or sex chromosome. It is a screening test, meaning it gives you a risk of having one of the above conditions; it is not a diagnostic test. Well known companies that offer this test include Natera, Progenity, Harmony, and MaternT21. It is also a way to find out the gender of the baby early on in pregnancy. Roberto and I agreed it was important to do the NIPT test before we made our pregnancy announcement to be sure we had a healthy baby on the way.

Third Time’s a Charm

At 12 weeks pregnant, it was time to do the bloodwork for the NIPT. Because my insurance provider had changed since my first pregnancy, I was directed to use Natera’s Panorama test as that was the in-network NIPT for my insurance provider. 

The day prior to having my NIPT test, I got a bad bout of food poisoning. I didn’t want to delay the NIPT test any longer, so I ate some crackers and drank some gatorade, headed to the lab, and got my blood drawn.

It took 10 days to get our results. The nurse called me and said the Natera Panorama test came back and it said “No Results”. What could this mean? It said there was some sort of laboratory error and they needed me to provide another blood sample. UGH! I figured it was because I had food poisoning. I felt like I wasted 2 weeks and we wanted to make our pregnancy announcement soon since I was starting to show. During this time, I also found out my insurance would not be covering the NIPT costs since I was not considered a high-risk pregnancy, so the cost would be out of pocket. 

At 14 weeks pregnant, I went back to the lab and did a redraw to have my blood sample sent in again. We waited another 10 days for the results. One morning, as Roberto and I were driving to work, I checked the Natera portal and saw the results were ready. We had been wavering back and forth if we would do a gender reveal party when his family comes to visit. If I open the results, I would see the gender of the baby. I was so eager that I told Roberto I didn’t want to wait and begged him to let me go ahead and open the results instead of waiting for the doctor to call. He obliged and we opened the results together.

The results said… NO RESULTS. Again. How could this be? Two inconclusive test results in a row. This time, the results said that there was a DNA pattern that could not be interpreted. What does this mean? Does this mean there is actually an issue with the baby or is it a lab error? I had also started to get sick recently with a bad cough (hint: the start of my cancer symptoms). Maybe it couldn’t read my DNA because I was sick and on various medications?

We had a checkup with our OB the following day. He said it was very unusual to get no result twice. However, he assured me for my age, I had less than a 1% chance of having a baby with a genetic disorder. He said it was up to us if we wanted to try another NIPT test. We still wanted to, even if it meant paying more out of pocket. We opted to go with Progenity, the same test I used with Camila.

So now at 16 weeks pregnant, I got my third NIPT test. We were hoping this would be the final one. I was also very much showing at this point and several people at work were suspicious. I told Roberto I wanted to go ahead and start sharing with people that I was pregnant because I really couldn’t hide it much longer. We both originally wanted to keep our pregnancy news private until we received the NIPT results, but since it was taking so long, I felt like I needed to go ahead and tell people. Roberto discouraged me from doing it, but I went ahead and shared the news with more friends and my coworkers. Prior to this, only close family and friends knew.

The Results

In just 5 days, my obstetrician called me on a Friday I was off work. He said my Progenity test results came back with a high risk of the baby having Down syndrome (extra copy of chromosome 21). The world completely stopped moving. How could this be? I’m healthy and only 33 years old; I have less than a 1% chance of having a baby with a genetic disorder. How could this happen? I asked my doctor how accurate this test is. He said they are usually pretty accurate, though it is a screening test to assess risk and not a diagnostic test to confirm a result. Is it possible the test is a false positive? Very unlikely, he said. My OB explained my options on what I could do next if I wanted to do additional diagnostic testing to confirm the NIPT test.

I tried to process it, but a million different thoughts raced through my mind. Was I fit to be a mother to a special needs child? Would it be hard on Camila to live a life with a sibling with Down syndrome? I already feel like I’m struggling now with a healthy child. How can I do it with a child that needs more? Other thoughts crossed my mind. Should we have a special needs baby knowing that we are not prepared? Could I live with myself if I terminated this pregnancy? What would I tell everyone when they ask what happened? They all know I’m pregnant now.

I called Roberto at work to tell him the news. I could not keep myself together. He came home from work and we cried together. We only wanted a healthy baby and now nothing was guaranteed for our family. We looked at the Progenity test results together and that’s when we learned the baby’s gender in the least exciting or joyous way. It’s a boy. It was hard to be excited knowing the challenges our family would face.

We shared the news with my parents. It was extremely difficult to look at my parents and tell them that there could be something wrong with the baby. My mom told me exactly what we needed to hear–that she would support us no matter what we chose to do. Our joy was their joy, and our sadness is their sadness. My dad prayed to his mother that everything would actually be fine and he said that his mom has never let him down we he needed her. Roberto also shared the news with his parents, but very lightly as he did not want to worry them. They said they would pray for us.

At this point, praying was all we could do. The reality is if the baby has Down syndrome, that already developed long ago in the beginning of pregnancy. There was nothing we could do to reverse it. For those not familiar with Down syndrome, it occurs randomly. It’s neither the mother’s nor the father’s fault and there is nothing you can do environmentally or behaviorally do to prevent it.

We had several plans that weekend and had to put on our best poker faces. We got asked by well-meaning friends if we were excited for baby #2. I had to avoid taking pictures because I didn’t even know if I was going to be pregnant much longer. We felt so helpless because there was nothing we could do but wait until the week to start to see specialists for our situation. We both did our fair share of Googling to read all sorts of stories that made our imaginations run wild. And there were lots of tears over the weekend. The one thing that kept us together was our shining light, Camila. She is so happy and full of life. We are so blessed to have her. Maybe she’d be our only child, because I don’t know if I could go through this again.

More Testing 

The following Monday morning, I get to work and start calling the maternal fetal medicine specialists that my OB’s office referred me to. I am desperate to get an appointment as soon as possible. I am 17 weeks pregnant at this point and I feel like time is running out for us to make a decision on what to do next if we were to consider other options (we never said what we going to decide on what to do until we were faced with a confirmed diagnosis). I am able to get an appointment the following day at the High Risk Pregnancy Center at Memorial Hermann Sugar Land. They explained to me that they would do a level 2 ultrasound, we would talk to the a genetic counselor, and if I decided to proceed, I could even do an amniocentesis that day. An amniocentesis is an invasive prenatal diagnostic test that uses amniotic fluid to test for chromosomal abnormalities. It is a highly accurate way to confirm if the baby does have Down syndrome or other genetic disorders.

We get to our appointment at the High Risk Pregnancy Center. There are so many emotions running through us. We’re scared, hopeful, nervous, sad, confused. The first thing we do is the level 2 ultrasound. This is similar to the anatomy ultrasound normally done at 20 weeks. We look at the entire baby and the ultrasound technician takes measurements and close-ups to identify any soft markers for Down syndrome. The high risk pregnancy OB reviews our ultrasound and confidently says the baby looks healthy! There are no soft markers showing up for Down syndrome! However, we can’t fully celebrate yet. About 50% of babies that do have Down syndrome don’t show any soft markers in their ultrasound. We are at least going in the right direction of good news though.

Next, we speak with the genetic counselor. She starts from the basics of genetics and we go over all three of my NIPT results. She explains that an NIPT test only tests for a limited set of genetic issues–specifically trisomy 13, 18, 21 (Down syndrome), and sex chromosomes. We have 23 sets of chromosomes, so it does not test for the others. NIPT test also reads placenta DNA, which is not necessarily the same as the baby’s actual DNA. She explains to us that since the second NIPT test I took had a result of DNA not being able to be read, it presents another situation to us. It is possible that my second NIPT test could not be read because perhaps there is an issue with a chromosome outside of what an NIPT test would pick up. So now, not only are we worried about the possibility of the baby having Down syndrome, but the baby could actually have another genetic issue due to another chromosome having an issue.

Both Roberto and I are in agreement that we do want to have more diagnostic testing done in order to confirm the baby’s state. The genetic counselor suggests in order to do this, we do an amniocentesis and then order three tests:

  1. The FISH test is a rapid result test that can accurately diagnose if the baby does or does not have trisomy 13, 18, 21, and any sex chromosome issues. It will basically confirm the NIPT results. The turnaround time on this test is 1-2 days, which would be a great way for us to get some quick preliminary results.
  2. A chromosome microarray (CMA) can look for extra (duplicated) or missing (deleted) chromosomal segments for all chromosomes as well as mosaicism in the chromosomes. This test can confirm if there are any issues with all chromosomes as it relates extra or missing segments. It takes 7-10 days for this test result to come in.
  3. A karyotype will review of all the chromosomes to make sure we only have a pair of all 23 chromosomes (no extra or missing chromosomes). This test takes the longest to be completed at 10-14 days. These three tests would give us high assurance and accuracy if there are any genetic issues with the baby.

The genetic counselor noted that nothing is guaranteed when it comes to testing a fetus. There could be other health issues that these genetic tests do not cover. The only way we would ever know if we truly have a healthy baby is on delivery day.

We asked the genetic counselor what was the chance the NIPT is a false positive. We thought this was the only way we could ever get the positive outcome we longed for. She said it can happen, but it’s not common. When it comes down to it, I think it’s a 1% chance of there being a false positive. The odds aren’t in our favor.

The genetic counselor never pressured us to go with one option or another. She laid out all of our options and let us decide what was right for us. We decided to immediately move forward with the amniocentesis and the three tests she recommended. They outlined the risks associated with having an amniocentesis which included a very small chance of miscarriage. In fact, several moms decline having an amniocentesis because they don’t want to risk miscarriage. We accepted the risks and moved forward.

The amniocentesis procedure itself took less than 15 minutes in entirety. They did another ultrasound to identify the baby’s position and then stuck a long needle into my abdomen to pull a small sample of amniotic fluid. It hurt but was over quickly. We went home feeling sad thinking about how in a couple of weeks we may be faced with a difficult situation ahead for our future as a family. We were also hopeful that there was a small chance of a miracle happening with a false positive.

Waiting for Results

My cousin Julie’s wedding was that weekend and we agonized about how tons of family and friends would be asking about my pregnancy. We’d have to pretend and say everything is fine, when in reality we were dealing with a devastating situation.

Here we are at Julie’s wedding trying to have fun despite a lot on our mind. I was also in a lot of physical pain since my cancer symptoms were so bad at this point, but I had no idea it was cancer.

We got a call from our genetic counselor two days after the amniocentesis, the Thursday before Julie’s wedding. She shared that our FISH results were in and they were normal! This confirmed that the baby does not have Down Syndrome nor any issues with chromosomes 13, 18 and the sex chromosomes. This was amazing news! Our prayers were being answered. We were on the right path to the NIPT being a false positive. This calmed our nerves and we now felt like we could begin to feel more excited about the pregnancy.

A few days later, Roberto and I were both home from work because we were both sick, including Camila. We got another call from our genetic counselor and our chromosome microarray (second test) results were in. They were normal! This meant that there were no chromosome micro additions or deletions, including mosaicism. It meant that we had more assurance that the other chromosomes didn’t have issues. We continued to move in the direction of getting the false positive we prayed for.

We had one last final test result to wait for–the karyotype. This test result takes the longest to get back, but would give us the final reassurance if the baby had any major genetic issues. We finally got the call two weeks after the amniocentesis. The results were normal! All three of our tests came back with normal results and the healthy baby we prayed for was closer to a reality.

At the time, the genetic counselor and obstetrician can’t explain why I got the NIPT results I did. They want to continue to monitor my pregnancy closely and we’d continue to pray for a healthy baby.

The Link to Cancer

It wasn’t until my cancer diagnosis that my high risk obstetrician stated that the NIPT scare was likely due to me having cancer. She said that cancers that affect the blood, like leukemia and lymphoma, often make it hard for NIPT tests to be properly read. We’re sharing our experience because there’s not much out there on false positive NIPT results, much less how cancer can be linked to it.

I have since shared my diagnoses with our genetic counselor and she’s working with a third party laboratory so I can participate in additional research with them. Hopefully, more will be known and advancements in genetic testing and cancer can be made.

We continue to pray for a healthy baby for the remainder of my pregnancy and chemo treatments. So far, he is doing great and growing well.

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.

My First Life Challenge

For a team building event at work, we were asked to tell our autobiography. Everyone around me told fascinating life stories about the hardships they endured, challenges they faced, and how that got them to where they are today. When it was my turn, I realized in my short 30-something year life I had a pretty calm life. I didn’t have any hardships. I had never endured any tragedies. I lived a very fortunate, blessed life, surrounded by loving friends and family. My childhood was full of great memories. I have a loving husband and healthy, smart daughter. I went to a top university and now have a career I love. I have hobbies I’m passionate about and get to enjoy regularly. By no means is my life perfect, but it is certainly blessed.

Now at 33 years old, I face my first big life challenge. At 22 weeks pregnant with my second child, I’ve been diagnosed with lymphoma.

The road ahead to fight cancer and adapt to a family of four is scary. But I know I can do it with my amazing support system by my side and the care of a top team of doctors. This is my fight and I’m ready to conquer it.

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