Pregnancy

The Love of My Life

In 2010, I was on a date with a man who wanted to talk a lot about my blog.

Him: Your stories would make a great book! Each relationship could be a chapter with the last chapter about the man you decide to marry and spend the rest of your life with!

I thanked him for the compliment and then paused before responding, “You know? I don’t think a man will be the love of my life. I want to adopt and become a mom. I think that my daughter will be the love of my life.”

Prior to starting chemotherapy for breast cancer, my oncologist asked me if I planned to have children.

“I’m going to adopt a girl who is of elementary school age,” I said, matter of factly. I didn’t need any information about freezing my eggs since I never envisioned getting pregnant or giving birth.

When I was going through treatment for breast cancer, I would picture the daughter that I would adopt as a source of inspiration. I couldn’t see her face, but I visualized her black hair in pigtails with a white cardigan over her navy dress.

I didn’t know then what I know now. I wasn’t meant to adopt. I was meant to meet The Man, fall in love and astonishingly conceive.

Medical professionals don’t typically use words like, “miracle,” but with my pregnancy, they did. During my bi-monthly sonograms, four different radiology technicians commented that my daughter-to-be was gifted and sassy. I would smile and remind myself that she was just a fetus. But, a part of me realized that even as a fetus, she had already proven that she was strong!

After the doctors delivered my daughter, Roya, one of them commented that my ovaries were postmenopausal. Medically, there wasn’t an explanation for my pregnancy or her birth. And yet, in spite of all the odds and obstacles, Roya was born.

I’ve heard from quite a few people over the past year that Roya’s birth has given them hope. It’s important to believe that the seemingly impossible is in fact possible. She is living proof that miracles can happen!

Several doctors and friends have commented that Roya is destined for greatness. Well, greatness is subjective and ascribes to certain conventional benchmarks of success. I hope that whatever the future holds for Roya, she realizes that she’s great just as she is.

On the eve of Roya’s first birthday, I held her in my arms with tears in my eyes. So much of the past four years was unplanned, but I guessed one thing correctly:

My daughter would be the love of my life.

And, she is.

A Tale of Two Foobs

I was watching TV when I felt a lump in the middle of my right breast. I raised my arm, and I could still feel it. I looked down, and it was noticeable to the eye.

“It’s just scar tissue,” I told myself. But, I immediately reached for my phone. I sent a message to my breast reconstruction surgeon, Dr. Kathy Huang, thankful that she was only a text away. She replied that she could squeeze me in for an appointment a few days later.

With health matters, I’ve worked very hard to get to a point where I don’t exert a lot of emotional energy over that which is unknown. However, since I’ve become a mom, I find myself edgier about any tests or appointments related to life in remission. The stakes are exponentially higher. Even though I knew that what I felt was most likely nothing, I couldn’t help but going to that place in my head for a few minutes. I didn’t even tell anyone, including The Man, about my appointment for three days.

I was clearly concerned, but I reminded myself of the recent study that indicates that carrying my pregnancy to term didn’t increase my risk of recurrence of my hormone-positive breast cancer. However, that’s not a guarantee that my cancer won’t return. As any “survivor” knows, we might be cancer free, but that doesn’t mean that our lives are free from dealing with cancer and the repercussions of our diagnosis.

The following week, I visited Dr. Huang’s office. After a thorough examination, she commented that she, too, thought the small mass was scar tissue. However, she recommended a breast ultrasound (sonogram) just to be sure. I headed to Sibley the next week for the ultrasound. When the breast radiologist indicated that the lump was in fact scar tissue, I let out a sigh of relief. I exhaled deeply again later that week when my internist informed me that my blood counts were good.

I am thankful that this turned out to be nothing. Yet, I can’t help but think of the loved ones and acquaintances who weren’t and aren’t as lucky. I remain humble and small in the face of this horrible disease.

So, does that mean I’m done thinking about my foobs (my post-mastectomy breasts) until my next MRI?

Well, not exactly.

As I mentioned earlier, I’m still dealing with the repercussions of my cancer diagnosis. The skin around my foobs sags and bunches. (That’s to be expected since I have a connective tissue disorder and got pregnant so soon after my double mastectomy.) I also have very pronounced scars across the entire width of my breasts and no nipples. Dr. Huang proposes another surgery to tighten up the skin. That would also minimize the appearance of the scars and lift my breasts. She would then construct nipples from the excess skin at the end of that surgery.

I miss having nipples and don’t like being so ambivalent about my breasts. I imagine that this surgery will leave me with much-needed feelings of fondness for my foobs. I also know enough about Dr. Huang’s work to know that the foobs will look much better after she works her surgical magic.

I had hoped to have this surgery over the summer, but a change in my childcare arrangement will make that difficult. I need to schedule this when I have ample coverage since I won’t be able to hold Roya for two weeks. The tale of two foobs must be continued…

Tips for Dealing with Bed Rest

Friend’s Question: My doctor has put me on bed rest during my pregnancy. Any suggestions for how I can get through it?

Answer: First of all, I’m so sorry to hear that you’re on bed rest. I hope and pray that all will be well soon.

(For those who aren’t familiar with what “bed rest” entails, it’s much more than just taking naps or getting a good night’s sleep! Bed rest is mandated by doctors to prevent complications such as premature labor during pregnancy. Bed rest could be required for a week or several months! As The Mayo Clinic describes, “If you’re on complete bed rest during pregnancy, you might not even be able to shower or eat sitting up.” Bed rest or a similar term can also be used to indicate medically-imposed restrictions following illness, injury or surgery.)

Here are my tips as someone who doesn’t directly know what you’re going through, but has spent a lot of time in bed or at home recouping:

Make sure your doctor is very specific as to what you can and can’t do in a given day. When in doubt, err on the side of caution and call the doctor’s office.

Keep your eye on the prize and do whatever you can to get through the day. The goal here is a healthy baby. As a mom, you’ll do anything in your power so that your child will not go through one added ounce of pain. You’re just starting that mode while you’re pregnant, instead of when your baby is here. Whatever you need to do, can do or want to do on a given day is all you should do. Period.

See about renting a wheelchair and talk with your doctor as to whether that can enable you to get around more, even if it’s just around your own house. Insurance might be able to cover that temporary expense, too.

Move into the room that you find the most peaceful (ideally one that’s also closest to a bathroom and doesn’t involve any stairs).

Figure out if you need help, want company or neither. There’s no right or wrong, but I feel as though some people get that you might need help with grocery store runs, laundry, dog walks, etc. They will offer to help and if you feel comfortable having them in your home, take them up on it. Other people will just think you want someone to chill with and will expect you to host them if they come over. Decide if you are up for that physically and emotionally. If you don’t feel like seeing people while on bed rest, it’s ok to say that you’ll check in with people once you’re able to get out and about.

Try to keep some of your normal routine. My hairdressers and nail techs offered to come to my house many times. I’m sure if your stylists and techs knew that you couldn’t come to them, they would do the same! If that would make you feel more like yourself, reach out to them.

Invest in whatever you can to make this time easier — a cleaning woman, a dog walker, food delivery service, stores that will deliver and assemble nursery furniture, etc… It’s worth it.

Ask your doctor for a case manager. A case manager can access your limitations and living situation and recommend solutions. Maybe you need a shower chair or to rent an adjustable bed? Maybe a prenatal physical therapist or home health aide could be of benefit? Case managers can also check as to what’s covered by insurance.

Consider if you want to connect with someone in the area who went through a similar experience during pregnancy. Sidelines is a nonprofit that provides such services. There are also online forums and women your doctor can connect you with.

Remove the pressure involved in having to use the time to write the next great American novel, journal, make a baby book or anything else. If you want to do any of those things, fine. If not, that’s fine, too.

So, readers, what are your recommendations for dealing with bed rest?

Am-boob-alent

I used to be the girl who was a little too comfortable parading around topless in the gym locker room.

Now, I’m the girl who changes in the shower stall as quickly as she can.

I used to be the girl who loved her real, full breasts.

Now I’m the girl who tries to not to look at her boobs.

How do I feel almost two years after double mastectomy? Ambivalent.

Or, would that be, “am-boob-alent?”

I’m thankful that I’m in remission (knocking on wood, while I type), but that doesn’t mean that there aren’t constant reminders of what was and how much my life has changed since my diagnosis. Since my reconstruction, my breasts are the same size as they were before the surgeries. But, they don’t feel or look like my old breasts because they’re not.

The media tends to focus on celebrities who had double mastectomies preventively like Angelina Jolie or who didn’t require chemotherapy and radiation like Giuliana Rancic. I appreciate that double mastectomies are not easy for any woman to go through. But, if the surgery is done preventively or the woman’s breasts don’t have other scars or burns on them, the surgery typically can be performed with smaller incisions and less obvious scars. How does that impact a woman’s thoughts about her breasts at a minimum or overall self-esteem and sexuality at a maximum?

Since I’ve had radiation, as well as biopsies and lumpectomies (12 in total over the years), I was not a candidate for any surgery involving smaller, less-noticeable incisions. As a result, my boobs have an equator-like scar around the entire width of both breasts. Given my connective tissue disorder and subsequent pregnancy, the skin around my breasts has stretched significantly. I need at least one and possibly two more surgeries to tighten the skin and add nipples. Several of my survivor sisters have found that getting nipples and completing reconstruction have made them feel more like themselves. I hope that’s the case, but that doesn’t change the fact that my old boobs are gone.

I might not like my post-reconstruction breasts or flaunt them, but I try not to let my “foobs” impede me from my day-to-day life and expressing myself and my sexuality. And, I do take comfort in the fact that having a double mastectomy significantly lowered my risk of recurrence. The reasons I had the surgery in 2012 are still valid today from a personal and a medical perspective. At the end of the day (again, knocking on wood), that’s what’s important.

How can you stay on top of your breast health?

PS This post was written by Stef Woods of City Girl Blogs™ of CityGirlBlogs.com. If you are reading this post in its entirety on another site, please know that said site is scraping my feed in violation of my copyright policy.

Sex during Pregnancy

It’s time to answer a reader’s question!

Question: I’m three months pregnant and ever since I told my boyfriend, he won’t have sex with me. He says he feels weird knowing our baby is in there and doesn’t want to hurt me. How can I convince him it’s fine?

Answer: Assuming that you have a healthy pregnancy without medical complications, sex is not only okay, but it’s encouraged! Many women report that their sex drive increases significantly during the second trimester and that they are able to orgasm with greater ease and intensity.

How much have you and your boyfriend communicated about his specific concerns? What exactly does he feel weird about? If he hears from your doctor or another reliable source that having sex with you won’t hurt the baby, will that assuage his fears? I would ask him to join you at your next doctor’s appointment or sonogram so that a medical professional can inform him that having sex during a healthy pregnancy is completely fine.

Before the baby arrives, talk to him about what you both are feeling. Pregnancy obviously affects men and women differently, and having a child will dramatically change the dynamics of your relationship. (Your life will go from all about each other to all about the baby like that *snap*, as well it should.) How will you try to make time for each other and be affectionate toward each other? How can he best support you during the pregnancy? How will you both prioritize the other person after the baby comes?

Despite the fact that many couples have to deal with the issue of sex during pregnancy, it’s not a common topic of conversation. Rest assured that both you and your boyfriend have perfectly normal and legitimate concerns. At an AASECT conference, I spoke with renowned sex educator Lou Paget about her book, Hot Mamas. Lou wrote this book “for moms-to-be who want to nurture their sex lives along with their growing bellies,” in recognition of the fact that many women don’t know what to expect.

Arm yourself with information through books like Hot Mamas, respected online sources and DVDs on Sex & Pregnancy to supplement your conversation with the doctor. Get ideas for comfortable positions to try during different stages of your pregnancy. Use the months before the baby arrives to try something new (a toy, perhaps?) or plan a romantic getaway. Spend a lazy day in bed, enjoying each other and the ability to sleep as often as you like!

To the Hot Mamas out there and the partners who love them, what recommendations do you have for this reader?

My Health Since Giving Birth

Back in October, I called my internist to ask if he thought I could safely carry to term. (He's cared for me for more than 13 years, and I value his expert opinion.) Dr. P. guessed that my health would improve during pregnancy, but dip after I gave birth. The only question was just what that dip would entail.

Since having Roya, concerned friends and readers have inquired about my health. Quite a few have commented that I'm glowing from the joys of motherhood.

I can’t deny that I do beam when I hold Roya in my arms, and I hope that feeling never stops.

stef woods, city girl, city girl blogs

Our second day together

But, if you saw me at 3am…or 5am…or 7am, I doubt you’d say I look glowing. I look like any exhausted parent of a newborn.

On the health front, there has been a dip, but it thankfully hasn’t been a dive. (That's the best I can hope for given the fact that three of my conditions are genetic.)

So…what's been going on?

Within two weeks of giving birth, my migraines returned to their previous pace of twice a week, every week. Luckily, though, I can take my old reliable migraine medicine when they hit.

Over the past seven weeks, I’ve had more low-grade fevers and swollen glands than I’ve had in years. (That combination of symptoms typically occurs when my body gets run down.) Yesterday morning, the fever topped 101, and the added chills and body aches made it tough to hold Roya without feeling dizzy. I count my blessings for wonderful babysitters that are willing to drop everything and help us out when we need them!

There's evidence of degeneration in six out of seven vertebrae in my neck. Holding Roya for hours on end isn't helping my neck pain and mobility. I'll be back in physical therapy soon to try to strengthen my neck and upper back.

I met with my radiation oncologist back in April. During a clinical breast exam, she didn't feel anything abnormal. I'll go for a breast MRI in a few months to confirm that all is still well.

The only thing that has improved since I gave birth is that I’m no longer vomiting incessantly. That means that I haven’t gotten dehydrated or needed to return to the ER since April. I’ll take it!

At the end of the day, though, Roya is (knock on wood) healthy, and my medical conditions are manageable. I’ll continue to do what's in my control to stay as strong as I can, but my health taking a dip is far less important to me than her being here!

“Priorities,” I think to myself, smiling and typing with Roya asleep by my side.

Truly A Miracle

Merriam Webster defines a miracle as:

An extraordinary event manifesting divine intervention in human affairs.
An extremely outstanding or unusual event, thing, or accomplishment.
A divinely natural phenomenon experienced humanly as the fulfillment of spiritual law.

I’ve written before about how I’ve been described as a medical miracle. It was also a miracle that I was able to conceive given my age and the fact that chemotherapy causes a woman's eggs not to be viable. Doctors have been referring to my pregnancy as miraculous, but none of us knew just how many odds had been defied until I gave birth.

While I was on the operating table during my c-section, Dr. OB exclaimed, “That's one old postmenopausal ovary!”

“Postmenopausal?!? Really?!?” I asked with surprise in my voice. I had been in menopause following treatment, but time had reversed some of the symptoms. Postmenopause occurs after menopause is completely over, and that's not typically the case for women after chemotherapy.

“Yes! Everything here is very sad and aged. One squeaked through, though, although we’re not sure how!”

This conversation transpired while the pediatrician was examining our daughter, Roya.

During my hospital stay, I started thinking about what the doctor had said. If my ovaries were postmenopausal, that meant that I had the ovaries of a woman in her 50s. A woman who is postmenopausal has no more eggs and thus no more periods. There was no way that I should have been able to get pregnant, and yet, Roya was here. She made it through the creaky, wrought iron gate that is my reproductive system. And, I'm so thankful she did!

I Can’t Breastfeed…Nor Would I Want To

“I wish I had gotten a double mastectomy so I would have had an excuse for not breastfeeding. I was in tears when Emily couldn’t latch, and the nurse kept forcing me to try.”

“Well,” I told my friend with an odd look in my eyes, “I’m very thankful that you didn’t have breast cancer or a double mastectomy. I just wish that there wasn’t such societal pressure to breastfeed and you hadn’t felt as though you were an inferior mother when it didn’t work.”

Since I announced that I was pregnant, I’ve received a lot of questions about whether I could breastfeed. I typically answer with a version of the following:

No nipples. No milk ducts. No desire.

If someone probes further, I let them know that even if I could have breastfed, it's far from ideal to pass more of my immunities onto my daughter. (I fully appreciate that there are proven health benefits to breastfeeding, but I don’t think women with my health issues were the subjects of any of these studies!)

Other factors that contribute to my views that the breast isn't always best:

Several of my friends who breastfed were exceptionally sleep deprived. That, in turn, played a contributory role in them suffering from Post-Partum Depression;
Since breastfeeding is the mother’s responsibility, I've noticed that the father often feels excluded or disconnected from parenting in the early stages. For numerous couples, that has led to resentments and relationship problems in the first months after having a baby;
Breastfeeding is linked to significantly lower libido in women; and
Quite a few friends found breastfeeding problematic because their children needed more milk than their breasts produced and/or their babies had trouble latching. They thus needed to introduce formula to supplement their breastfeeding while they were in the hospital. A desire to breast feed doesn't necessarily translate into the ability to do so.

(The above list is a collection of my observations from a dozen friends who have struggled with breastfeeding.)

Pediatricians recommend breastfeeding as the preferred option, but it concerns me that it's viewed societally as the only option. I don’t regard such absolutes as healthy, as they exacerbate the pressures of caring for a newborn in the midst of dramatic hormonal changes. A woman is not less of a mother if she doesn't breastfeed, and no one has the right to make her feel that way.

Throughout my pregnancy and since giving birth to Roya, I was never asked the simple question, “Are you breastfeeding, bottle feeding, or both?” Everyone assumed that I was breastfeeding. Telling people, even health care professionals, that I’ve had a double mastectomy tended not to resonate either. A double mastectomy isn’t a boob job! During a double mastectomy, everything under the skin is removed. Everything. I also didn’t have the luxury of having nipple-sparing surgery since I was diagnosed with invasive breast cancer. Despite the biological impediments to me breastfeeding, I still find it fascinating that people automatically presume that I would want to breastfeed.

Breastfeeding like so many other parenting decisions is a choice. Choosing to bottle feed should not be met with judgment regardless of the reason for doing so. I’ll respect your choices as to what’s best for your family. All I ask in return is that you respect mine.

What’s in a Name?

Deciding on a baby name is one of the sweetest parts of the pregnancy process. Since we chose to keep the name a secret until Roya arrived, I had yet to share with you how we came up with the name. Until now…

Late in 2012, we had picked out several girls’ names. One of my friends recommended that I conduct a Google search on all the names we were considering. And, boy, am I glad she did! A search revealed that a woman with one of our favorite girls’ names, Devin, and the same last name had a very gifted career as an adult film star. (Although I respect Devin's professional choices, I feared the possibility that my minor daughter could someday be mistaken for an adult film actress.)

We thus went back to the drawing board to find a new name. While watching Homeland one Sunday evening, The Man suggested the name, Roya, after one of the characters in the show’s second season. On the show, Roya Hammad is a London-educated, beautiful, brilliant journalist. She aligned herself with Homeland's antagonist, Abu Nazir, but gave a sense of honor to her character’s actions.

Zuleikha Robinson (Roya Hammad)

After hearing his idea, I responded, “Oooh! I really like that name! I wonder what it means…”

While the episode continued to play, I searched on my phone for more information about the name. Roya is most common as a Persian girls' name, but it’s also Arabic and Turkish. Once I saw the name’s meaning, I went from liking the name to loving the name.

Roya means “a dream come true, a vision or premonition, or a fantasy.”

The following day, we both found ourselves thinking about the name and how much we liked it. We had found the name for our little miracle! We didn't need any alternatives. She would be named Roya. Now that she's here, the name suits her even more than I thought it would!

As a post script for those who haven't heard the name before, the English pronunciation for the name is "Roy-a," as though you're adding an "ah" to the name, "Roy."

The T-Shirt That Made Me Cry

The Man describes me as a sentimental unsentimentalist. Or, maybe I’m an unsentimental sentimentalist? However you phrase it, he's right. When it comes to my personal relationships, I’m incredibly sappy. (Why, yes, I’m the girl who is tearing up in the card aisle at CVS after finding the perfect card for a loved one!) On the other hand, I view many things, including pregnancy, pragmatically. That is, until I put on a t-shirt.

“What t-shirt caused me to have tears streaming down my face?”

The Survivor T-Shirt for the Komen Global Race for the Cure.

Several of my friends and I have participated in the walk for the past several years. However, I haven’t raised money for Susan G. Komen since the Planned Parenthood debacle. My tolerance for linking the cause to all things pink has also waned. Nonetheless, I’ve felt it important to register and walk with my breast cancer sisters and other supporters of the cause.

This year’s walk was held on May 11^th, which was a rainy day in Washington, DC. I deferred to one of my best friends who has lost far too much to this disease as to whether we would actually brave the walk or just meet for brunch after. She chose to bypass the rain and focus on brunch.

When I awoke on the morning of the 11^th, I decided that I would walk my own 5K down to the National Mall for the closing ceremonies, then to brunch and then back home. I put on the survivor shirt that Komen sent me and went into the bathroom to finish getting ready. The walk happened to coincide with the week that my belly had finally grown past my boobs. As I looked in the mirror, I noticed that the first three letters in survivor hugged against my baby bump.

I proceeded to cry…hard. I cried for all that had transpired in the less than three years since my diagnosis. I cried for what I had lost, but far more importantly, I cried for what I had gained. I cried for the fact that not only had I survived, but I was giving birth in less than three weeks! Despite all the odds, my body was doing something normal and healthy!

I dried my tears, finished applying my makeup and headed down to the Mall. I found myself beaming and actually embracing my growing belly with pride. I lost count of the number of smiles, looks of surprise and comments that I received. My smile got progressively bigger with each "Oh My God!" and "Wow!" that I heard!

At a recent conference for Young Survivors, attendees to a session on fertility were told to expect that they would never get pregnant. Maybe they won’t. But, it’s worth spreading the word about organizations such as Fertile Action devoted to helping women preserve their fertility before they start treatment. And, it’s worth believing in miracles since they do happen despite all odds! The fact that my daughter is asleep in my arms while I type is proof of that!