take what you need
From a telephone pole in Rockland.*

Since being diagnosed, many people have said to me that they admire my strength and courage.   While I don’t argue that I am strong and I have courage, I am convinced that most everyone in my position would do what needs to be done.  When you have cancer, you have two choices: work on living or give in to dying.  It’s a bit of a no-brainer.

For the most part, I have accepted cancer with pragmatism.  Cancer happened to me because cancer has to happen to someone.  I wasn’t divinely chosen or tested.  I don’t get bogged down in moments of “Why me?” because there isn’t a good answer to “Why not me?”

But there are times when this delicate acceptance becomes strained and I wish so badly that cancer wasn’t a part of my life.  Now is one of those  times.

Three weeks ago, while I was camping with my family on Cape Cod, I was struck by immense exhaustion.  The exhaustion was so overpowering that I immediately suspected its cause.

As I drove into town on the second to last night of our trip, I made a detour to the pharmacy.  I bought a pregnancy test.  I took it into a local public restroom and within 30 seconds I had confirmation of my suspicion: pregnant.

When I read the positive on the pee stick with my son and daughter, I was overcome with disbelief followed by nervous excitement.  This time, I was overcome with complete sadness and hopelessness.

I drove back to the camp site sobbing and wiping tears so I could still see the road.  I showed up and presented the news to my husband who immediately knew the implications.

I had emailed my oncologist in a panic as soon as I learned I was pregnant and she called back immediately to schedule an appointment for the first morning we would be home.

In the meantime, I started my research.  I learned that Herceptin, the drug that targets my specific form of cancer, can sometimes cause birth defects, but not all times.  I knew that I had already received a large Herceptin dose while pregnant.  I also learned that pregnant women who have breast cancer can get chemotherapy starting in their second trimester, and saw pictures of cue-ball bald women holding newborn infants.

On the morning of my appointment, a Friday, my husband and I went into MGH with heavy hearts.  I was feeling the worst I had felt throughout my entire cancer journey.

When the oncologist came into the room, the first things she said, is “Everything is going to be OK.  We are going to figure this out and support you no matter what you do.”  She then laid out my options, reiterating the information I had found while scouring the Internet.  I could keep the baby but risk a birth defect from Herceptin.  I could do chemo but I’d have to wait for my second trimester.  And radiation would have to wait until after birth.

All of the additional waiting would increase the chance of a cancer recurrence because only half of my treatment had been completed.   While we waited in the exam room, she made phone calls to set up ultrasound and OB appointments for the following Monday.  She said goodbye to us with reassurance and a hug.

On Monday, I had first had my ultrasound.  A doctor, who I later learned is MGH’s pregnancy-with-cancer specialist, came in at the end of the appointment.  He said the embryo was 3 mm long and the pregnancy was between 5 weeks and 5.5 weeks along.  And then he said that they couldn’t see a heartbeat and the embryo was probably not alive.

This is from the report that’s now in my MGH record, “Although it is too early to make the diagnosis of an early embryonic demise, we can see the fetal pole very well today and do not see fetal heart motion. This most likely represents and early spontaneous loss.”

An hour later, I met with an OB/GYN doctor. We scheduled a D&C for Wednesday, two days out. She said it was very possible I could miscarry on my own in the meantime.

I didn’t.

Our good friends helped us through those two difficult days–the night before and the day of the procedure. We stayed overnight at their South End condo so they could watch the kids since Keith and I had to be at the hospital by 6 a.m. All of the doctors and nurses were caring, sympathetic, and sensitive to what I was going through.

It’s now been two and a half weeks and I’m left with a grief I never could have predicted. There’s no doubt that I did what had to be done.  Even though that embryo was probably dead, I can’t help but wonder if it was a boy or a girl.  I look at my awesome children and think about how my husband and I weren’t able to welcome the third to our happy little family.  I feel guilt that I became pregnant and that my body was so toxic that it couldn’t sustain life.   And even if it could, I would have had to end it to save my own.

Nine months after my cancer diagnosis I am feeling anything but pragmatic about this disease.  Sometimes, it’s just plain awful.

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*I took the “courage” tab.

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