Well, it doesn't look like the worst case scenario is what I thought it was when I got pregnant or even 2 months ago when I shared the pregnancy news with everyone. The plan was to watch tumor markers and rescan after baby arrived and get aggressive then if something should have arisen.
Something has arisen. A couple of things actually. I guess I'll start with the pain: After the intense morning sickness subsided and I managed to get my hemoglobin levels up, I started noticing achiness and feeling "off." Being that this is my fourth baby, I simply chalked it up to being pregnant. I mentioned it to both my OB and my oncologist and they weren't too concerned either. Until my tumor markers went up and the ache became PAIN. My hips hurt. My thigh bones hurt. Regular Tylenol wasn't touching it. I was waddling and limping already. Around 16-17 weeks, I asked to do something about it. I was sent ASAP for an x-ray of my pelvis, lower back, and femurs as that was where the pain radiated from. (Sounds like pregnancy pain, right?) Doc called me later that same day to report that radiologist found "sclerotic lesions consistent with bone metastases." Even as I know the pain I was feeling wasn't normal, I was not expecting THAT. Because I was still so early in pregnancy, the oncologist was hesitant to order any more tests or procedures. The focus needed to be on growing a healthy baby, so I was prescribed narcotics for pain relief.
Because I was favoring certain parts of my body, I managed to throw out my spine in my lower back. This pain was totally different than the other pain- pinching versus throbbing. In most positions I felt it and there was nothing I could do about it. The two different issues combined made it almost impossible for me to function. I couldn't stand. I couldn't sit. I couldn't lay down. It took all I had to get through work (I now only work 12 hours a week) and when I came home I was useless. I HATE feeling like that. That's not who I am. Because I knew the two issues were not the same, I decided to see a chiropractor for the first time in my life. I was really hoping for immediate relief, but it didn't come. Sure I felt better, but I didn't feel whole. I continued with my appointments, if only for the massage I got while there. :) It turns out that after 6 adjustments, I no longer have that pinching pain. (The leg and hip pain is still there.)
And because I decided to go to the chiropractor, I am now "half-chested." The tissue expander that had been radiated popped. I woke up last weekend to one side of my chest being almost completely deflated. To be honest, I never really even thought of that problem. I know plenty of women who have implants who see chiropractors for adjustments. I assumed the fact that they were thick tissue expanders made them even more resilient than regular saline or silicone implants. I guess not. I guess it was bound to happen- to me. However, I will say that I would rather be half-chested than to continue to be in the excruciating pain that I was. At least I can carry about daily tasks. I saw the plastic surgeon right away and he said that there is essentially no risk to leaving things as is. He would be willing to coordinate surgery schedules to exchange the expanders for my permanent implants IF I have to have surgery before baby's arrival. However, the same concept applies as before- he will not do an elective surgery on a pregnant woman. If we have to wait, we have to wait. If we have to start the expansion process all over again, then it is what it is.
I also got the news last week that the focus on growing a healthy baby before we start the fight against the cancer again might be in vain. Some of you know, some of you don't, that I have certain antibodies that make me high risk during pregnancy. Both of my boys had to be monitored closely while in utero to make sure that my body did not attack them. I have monthly titre level checks to make sure that the antibody levels stay low and are not on the offensive. Guess who's antibodies are now on the offensive? Yeah, this girl's. My levels jumped from week 15 to week 20 to double the amount that doctors start to worry. They never got that high with the previous two pregnancies, especially at only 20 weeks. Because of the whole cancer thing and because no major complications occurred with the last two pregnancies, this wasn't exactly at the forefront of my mind. Silly me for thinking things would be smooth sailing.
I had an amniocentesis on Friday, May 9th to see if baby has the antigen that my body seems to be trying to fight. This baby will also be closely monitored by ultrasound to make sure he doesn't become anemic and stop growing and thriving. As of Friday, 21 weeks, his estimated weight was already 1 pound, which is good. My perinatologist is already talking about intrauterine blood transfusions for baby, and that scares the crap out of me. My amnio was traumatic (worse than any "awake" cancer treatment I have had!) and a transfusion would be done the same way. However, of course I would take any action that will keep baby safe and healthy- including delaying any cancer treatment that might be needed or enduring in utero transfusions.
I found myself in the hospital on Tuesday night. I had been having soreness in my upper abdomen for a couple of days when I just couldn't catch my breath anymore. The severe pain is right under/below my lowest left rib. I can't sit up, I can't bend over, I can't reach, I can't lift. I can't take deep breaths. Something is definitely up. When I got to the hospital, they took my word for it that it really had nothing to do with baby. (This is my fourth one, I'm pretty aware.) They did a physical exam which was excruciating. The OB that was there that night order a whole bunch of labs to check all my organ functions. And guess what came back normal? I have not been running a fever. The symptoms are *only* severe pain and swelling. He had no answers for me. We left the hospital with a prescription for some stronger narcotics and the assumption that it's either a pulled muscle in my rib cage or a popped/cracked rib.
Because we got no answers from the hospital, my oncologist sent me for ultrasounds and xrays today. These will be the comparison ones to see any progression of the sclerotic lesions (I'm already referring to them as metastases though have yet to be diagnosed as such) as well as looking at my vital organs for any abnormalities and looking at the rib area for clues on what the pain is. I don't go back to see him until next Wednesday, the 21st. I figure if there is something emergent, he'll call me, but if not, I just continue to take one day at a time.
So what's the plan from here on out? Well, one day at a time. The longer I can keep myself and baby boy healthy, the better. I'm trying to take it easy, but that's a lot easier said than done- I'm still working and I've got three kids I have to be responsible for. The results of the x-rays will determine the need for either immediate or delayed attention to the cancer. If things have progressed quickly in the past 5 weeks, we will have to do a bone biopsy surgery under general anesthesia (perhaps coordinating surgery with an implant swap?). That will determine TYPE of treatment. I am able to do chemo in my third trimester if it comes down to it. The amnio results will determine level of care for baby. If the results are positive for the antigen, ultrasounds will probably be weekly. If antibodies continue to increase and baby develops anemia, we do the intrauterine transfusion. If that doesn't work, we deliver early.
I just want to feel good again. I can't help but wonder "what next?" all the time. Are little aches and pains just that or do they mean something else? But it is what it is. With the new day comes new strength. It's tough and incredibly frustrating, but there is no other choice. I appreciate any and all prayers for my family, my baby boy, and myself.
