Stef Woods

The Next Hurdles (aka Stepping away from the Placenta)

November 13-15, 2012

I was 11 weeks pregnant. I still had two weeks left in my first trimester, but I had managed to get to this point without much fatigue or any morning sickness. (The latter was especially ironic since I had thrown up almost every day in August from my neurological conditions when I wasn’t pregnant!)

I had the Counsyl blood test and sighed in relief upon hearing that Little Bit tested negative for cystic fibrosis, sickle cell anemia and 100 other genetic diseases.

The next hurdle to jump over was chorionic villus sampling, also known as CVS testing. That test could rule out Down’s syndrome and other chromosomal abnormalities.

Why was I getting this test, rather than waiting four-six weeks for the more popular amniocentesis?

Well, at my age, I had a 2.2% chance of having a baby with Down’s syndrome. I wanted to have as much information as I could as early as possible in my pregnancy.

Upon arriving at Georgetown University Hospital, the fellow performed a sonogram before the procedure started. The fetus measured at the right size for 11 weeks and still had a strong heart beat.

The CVS test involves inserting a catheter through the cervix and removing some of the placenta. As the head of the OB department tried to begin the procedure, she had trouble moving the instrument inside me because Little Bit was blocking the entrance. I watched the monitor and saw that the fetus wasn’t budging no matter how much the doctor poked and prodded.

I chuckled to myself and thought, “That’s my stubborn kid in there.”

The doctor tried to go around the left side, but to no avail.

“If we can’t get a sample from the right side, we might have to go through your abdomen,” the doctor said.

I breathed deeply and responded, “I hope it works then.”

Thankfully, it did, and the doctor obtained the necessary cells from the right side. For those who were wondering, I didn’t find the procedure to be painful. It is uncomfortable, though, because you need to have a very full bladder for the entire time. (In my case, that was almost an hour.)

As I got up from the table, the doctor approached us with a full petri dish.

“Look what a great sample we got from your placenta!”

The Man stepped back, and I looked at the doctor with shock.

“We don’t need to see that!” I exclaimed.

“But, it’s a beautiful piece,” she informed us.

“Great! Then go do with it what you need to, but we don’t want to look at it.”

My expression and tone must have convinced the doctor that we really didn’t need to bond with my placenta. She headed off to the lab with the sample.

Upon her return, she instructed me to take it very easy for the next four days to reduce the risk of any complications. (There's a 1% chance of a miscarriage from the procedure.) There was mild cramping for the first 24 hours, but that was it. I was told to expect bleeding and not merely spotting, but I had neither. If you’re a woman who is considering the procedure, I highly recommend it, as long as the test will be performed at an experienced medical facility.

What were the results of the CVS test? Did I decide to find out the gender since the results also look at the 46th chromosome?

To be continued…

The Second Hurdle

November 5, 2012

I jumped over the first hurdle and prepared to face the second hurdle of my first trimester. I headed off to my appointment with Dr. OB. After taking a thorough health history, she began the physical exam.

When Dr. OB felt my belly, she exclaimed, “You’re growing nicely!” I smiled and exhaled. Then she placed the heart rate monitor on me. Within a few seconds, I could hear the fetus’ heart beat.

“156. That’s a strong heart beat.”

My smile and my sigh of relief got bigger.

As the exam continued, Dr. OB commented, “You have the perfect pelvis for pregnancy. Everything feels beautiful!”

I couldn’t help but laugh out loud. In 39 years, no doctor had ever commented that anything on my body was perfect from a medical perspective. Maybe it was about time?

The second hurdle was behind me. 

Upon checking out with the billing representative, I was informed that I needed to take a first trimester prenatal class.

“Is this one of those classes for expectant women who have never had any health issues to stress out and be all sentimental about being pregnant?”

Dr. OB said, “No,” at the same time that the billing representative chuckled and nodded in the affirmative.

I shook my head. I fully appreciate that for most women, pregnancy is the most significant health experience they have been through up until that point in their lives. My journey is just very different. 

I’m also far more pragmatic about being pregnant than sentimental. After dealing with so many health issues, that approach is second nature to me. And, I want this child, but I never wanted to be pregnant. The process, miraculous though it is given all I have been through, is a means to an end.

“Since there are still a few hoops to jump through over the next month, would it be possible for me to take the class in December?” I inquired.

Thankfully, Dr. OB indicated that would be fine. (I understand that the doctor’s office wants to assuage the fears of newly pregnant women, but a part of me thinks it would be very difficult emotionally to sit through a two-hour class about your pregnancy only to miscarry shortly thereafter.)

The billing representative then interjected eagerly, “Oh! I almost forgot to give you your gift!”

“Is it some mom-to-be gift?” I asked, rolling my eyes for a second time.

“It’s a journal!” she exclaimed. 

“I’m good. Thanks. I’ll write about this later on when I feel like it.”

I left with a feeling of peace that all was growing, as it should be. A part of me wondered, though, if I was the only pregnant woman who was very excited about the prospect of having a child, but didn’t rejoice in every minute aspect of the pregnancy. I didn’t think I was.

To be continued…

The First Hurdle

October 25– 31, 2012

I had a plan in place for my first trimester. I visualized each step within the plan as its own individual hurdle.

  • I was only eight weeks pregnant. At my age, I had a 30% chance of miscarriage. I needed to get through the next five weeks so that the first trimester was behind me.
  • My first official appointment with Dr. OB was in early November. It was another important milestone for us to hear the heartbeat and her to feel that everything was growing as it should be.
  • If I was able to carry through mid-November, I would have a blood test to determine whether or not the baby-to-be would have one of more than 100 genetic diseases. I would also get a minor, invasive procedure to check for chromosomal abnormalities, including Down’s syndrome, in the first trimester.
  • And, finally, I needed to see how I fared without the very strong migraine medicine that I had used twice a week for the past nine years. (Prior to starting that medication, I had been in and out of hospitals for chronic migraines, vomiting and dehydration.)

A migraine hit me on the evening of October 24th. Dr. OB had prescribed me Tylenol with Codeine, which didn’t do much of anything. I awoke the following morning and headed off to my interview on Let’s Talk Live. The migraine was so intense by that point that I threw up immediately before and after I was on air.

The migraine and vomiting continued with a vengeance for another 36 hours. That weekend, there was a scheduled evacuation of my building for an electrical shutdown. What I had thought would be a great staycation ended up with me asleep and sick for the majority of my time at The Dupont Circle Hotel!

I awoke Saturday evening and exhaled when I realized that the pain in the left side of my head was gone. I had gotten through two days without my migraine medication, and I did so without needing any IVs.

I closed my eyes and visualized the track of my first trimester. I had jumped over the first hurdle.

A few days later, I was walking my dog and let my mind wander. For the first time in my life, I saw myself with my newborn. For someone who had never imagined herself pregnant or with a newborn, that was a significant moment.

I put my hand on my belly and said out loud, “We’re going to through this, aren’t we? You’re a strong one.”

And, I looked up at the sky and said, “Thank you.”

How did the next hurdles go? That, dear readers, is for another post.

To be continued…

What’s the Right Way to Deal with a Cancer Diagnosis?

Every month, I receive calls from women who were recently diagnosed with breast cancer. Almost all of these women ask me the following:

How should I deal with my diagnosis?

My answer is always the same:

There is no right or wrong way to deal with having cancer. Just do whatever you need to do to get through this. Friends of mine have been criticized for not talking about their cancer enough. I was criticized for talking about it too much. It’s easy for people to speculate how they will feel upon hearing that they have cancer or require chemotherapy, but no one really knows how they’ll react until it actually happens to them.

This advice isn't difficult to comprehend or heed in theory, but in practice, that's another story entirely.

As I continue talking to each of these women, there is usually mention of a loved one who is responding differently than she would have hoped for or expected. There’s always at least one person in her life that accuses her of using cancer to get special treatment. There’s that boss or co-worker who believes that treatment or surgery shouldn’t impede her from attending to all her work responsibilities at the same pace as before. There are those who don't understand why she isn't back to her old self immediately after treatment is over.

It should be enough to respond to these criticisms or comments with, "This is cancer! This isn't a cold!" But, it's not. The challenge in dealing with how others process our cancer is compounded by the fact that most of us have a natural inclination to try to please others. We want to do the best that we can in every role that we play. We want to make our loved ones and our employer happy. We try not to be selfish or self-absorbed.

With cancer, however, we need to focus on ourselves. We need to set boundaries and put our health first every minute of every day. We can’t worry about how other people deal with our cancer; we have enough to worry about in dealing with the disease ourselves.

As a final piece of advice, I remind the patient to go easy on herself. The average woman who contacts me is in her 20s or 30s. This experience is likely to be the most significant and difficult journey in her life up to this point. And, unfortunately, the overwhelming majority of people her age won’t have any frame of reference. Nonetheless, it’s important for her to talk about the experience when she feels comfortable doing so and asking for help from at least a few loved ones. There will be those people who don't get it, but thankfully, there will be some who do.

So, readers, what advice would you give to people newly diagnosed with cancer or a major illness? If you've had a loved one battle cancer, how did you show support?

50 Shades Mania

I’ve never been one to shy away from controversial topics or criticism. It thus seemed appropriate to acknowledge and respond to some comments that have appeared below the USA TODAY College, Daily Beast and Daily Mail UK articles about my upcoming class on The 50 Shades Trilogy.

Comment: The class isn't academic in nature because the book series is porn or fluff.

Response: If I only required the students to read the three books in the trilogy, then that statement would be valid. However, that's not the case. The students in the class will be required to read 60 additional sources. Those sources range from a law journal article regarding whether Internet fan fiction violates copyright laws to chapters of human sexuality textbooks to public relations reports. This is an upper-level class, and the assignments reflect that.

Comment: It is erroneous to claim that “no other contemporary text on sexuality has transformed American culture the way that this series has.”

Response: One commenter regards a "contemporary text" as all texts since World War II. While that's one valid interpretation, I view contemporary as the digital age. Would the resounding commercial success of EL James’ books have been possible before the advent of e-readers and social media marketing? I personally don’t think so, but that’s for the class to debate in light of our other readings on the topic.  

With respect to whether or not the trilogy “has transformed American culture,” 20 million copies of the book were sold in four months. The series’ popularity has inspired the publishing industry to alter marketing strategies and the types of books that are being promoted. The trilogy has led to a sexual resurgence, a myriad of perspectives on “mommy porn,” and a 50 Shades of Grey baby boom. The media speculates on a daily basis about which stars will be cast as Anastasia and Christian Grey in the movie version of the trilogy.  The writing in the books has also sparked discussion about what has literary or artistic value. There’s a subjective element as to how one defines “transformed,” but I maintain that there’s ample evidence to support the books’ significant influence on present-day American culture.

Comment: Stef Woods doesn’t belong in academia.

Response: You're obviously entitled to your opinion. Nonetheless, my student evaluations, receipt of AU's Teaching with Technology Award and involvement with campus organizations demonstrate that teaching is a good fit for my skill set. If you’ve attended one of my past classes, panels or presentations and have any suggestions for improvements, please don’t hesitate to contact me.

Comment: As a parent, I would view this class as a waste of my tuition money.

Response: This class will have value for the students taking it, and that value will be evident to parents and potential employers alike. Learning outcomes for the class involve improving students' critical thinking, writing, editing, and public speaking skills. Students will also learn how to analyze and implement effective marketing and communications strategies. The lengthy reading and writing assignments will help to further these course objectives. 

Comment: Students enrolled in The 50 Shades Trilogy will be unable to find jobs after they graduate.

Response: My students have fared incredibly well in the job market. That’s a testament to their commitment to their schoolwork, extracurricular activities and internships. One-fifth of my Activism and Social Media students leveraged their final projects for my class to obtain paid positions in their desired field. 

I hope and expect the same for my students in The 50 Shades Trilogy. Over the course of the semester, students will be required to write a sexual genogram and three papers for a total of at least 25 pages. I crafted the paper questions to provide the students with strong writing samples regardless of their majors.

Have any questions or thoughts about my upcoming class? If so, feel free to comment.

Making a Plan

October 23-24, 2012

I awoke the morning of the 23rd and began reframing my thoughts around being pregnant. If my doctors were comfortable with me trying to carry, what steps could be taken to make this work?

I needed more information to be fully prepared for my consultation with the high-risk obstetrician. After an hour of research on reliable medical sites, I headed off to my appointment feeling both positive and pragmatic.

Dr. OB was compassionate, intelligent and appreciated the uniqueness of my case. Once we had reviewed my lengthy health history, Dr. OB asked about why my gynecologist had referred me to her.

“Well, when I made my initial appointment with you, I had assumed that I was going to be terminating my pregnancy. But, that was before my entire medical team gave me the okay to try to carry to term. Now, I want to hear if that's possible from your perspective. I have a plan that I feel comfortable with, but since you’re the OB, I'd love to get your thoughts,” I explained. “There’s a part of me that realizes how many odds had to be overcome for me to even get pregnant.”

“This is a miracle!” Dr. OB exclaimed.

“I agree. And, I’ve wrapped my head around the idea of having a child. But, I’m still only seven weeks into my pregnancy. It's so early! There’s a 30% of miscarrying at my age, right?”

“Yes,” the doctor responded.

“Enough of my friends have miscarried that I don’t take getting through the first trimester for granted. I also haven’t been without my migraine medicine in nine years! Back then, I was in and out of the hospital for chronic migraines, dehydration and vomiting. If I'm in and out of the hospitals with migraines over the next few weeks, then that would be a sign to me."

"Okay," the doctor stated.

"And, I was wondering if I could get Counsyl and CVS testing and results within the next month. [Counsyl is a blood test that screens for more than 100 genetic diseases that can be passed on in utero. CVS or chorionic villus sampling involves removing a tiny portion of the placenta to test for Down’s syndrome and other chromosomal abnormalities. Unlike an amniocentesis, CVS testing can be performed in the first trimester.] If any of the test results came back with an abnormal result, I would view that as a sign that this wasn’t meant to be.”

Dr. OB nodded her head and said, “That sounds like a good plan.”

She looked down at her calendar as she continued, “We could schedule the CVS test anywhere between the 15th and the 21st of November. That should give us enough time to schedule the procedure if any of the results come back abnormally.”

She paused and smiled, “But, I think we can get you to term.”

I smiled, as I responded, “I hope so!”

And, I was. I found myself calm as a plan was in place with tangible checks and balances. Every day, I prayed:

“God, I believe this is your will…that this is a miracle. But, if that’s not the case, please send me a sign over the next month. Otherwise, please watch over me and Little Bit and let us both be okay. Amen.”

I had only known I was pregnant for eight days, but it had already been quite the journey! I hoped and prayed that it was only the beginning of the journey, but time would tell.

To be continued… 

Getting More Information

October 19-22, 2012

I headed off to North Carolina to relax with several girlfriends at lake house. I didn’t think much about being pregnant while I was away since I assumed that the odds of the doctors letting me try to carry to term were so miniscule.

When I returned to DC from the lake, I couldn’t avoid reality for any longer. As I spoke with my gynecologist, she indicated that I didn’t seem 100% comfortable with terminating the pregnancy.

“I guess that’s because I’m not,” I responded. “There are so many health concerns that I bring to the table! But…there’s this part of me that feels as though this is a miracle…that so many odds had to be beaten for me to even get pregnant…what if this is part of God’s plan?”

“Well, what do your oncologist and neurologist say about this?” the doctor inquired.

“I haven’t called them,” I admitted. “I just didn’t want to hear that this wasn’t possible from all these doctors since that would make this even tougher.”

“I think you need to get more information so you truly know what your options are.”

“You’re right. Thanks!”

On Monday, October 22nd, I spoke with six of my doctors.

I wish that I had video of their reactions at the news that I was pregnant at the age of 39 after chemotherapy-induced menopause. One of them cursed. One started to stutter. One of them was silent. And, not surprisingly, all of them were shocked!

It was my turn to be shocked, though, as my entire medical team ranged between neutral and excited about me trying to have a baby.

My oncologist informed me that previous research had discouraged breast cancer survivors from getting pregnant within several years of finishing treatment. However, a recent study indicated that pregnancy would slightly reduce my risk of recurrence.

“The researchers couldn’t say why that was the case in the women who were studied,” my oncologist continued. “It might be psychological, but no one really knows.”

My neurologist said that even though my migraines weren’t hormonal, pregnant women typically experience fewer migraines than when they’re not pregnant.

“Pregnancy could actually be good for you!” she surmised.

My internist has known me longer than any other doctor. He explained, "I think you could safely carry to term, but I’m more worried about how your health will be after you give birth. You would need a lot of extra support to ensure that your other conditions don’t get worse or that if they do, your baby would be well taken care of."

“I had figured that much. We know how my health is when I don’t get enough sleep, and newborns are the antithesis of a good night’s sleep!”

I hung up with my internist and felt both positive and pensive. The medical obstacles that I had thought would impede me from trying to carry to term were no longer.

Could this actually be possible? And, if it was, did I want this to be possible?

I had always planned to adopt because I never envisioned myself pregnant or parenting a newborn. The expression, “If you want to make God laugh, make a plan,” kept going through my head.

I had an appointment with a high-risk obstetrician in two days.  I had some time to formulate my thoughts, and I knew that I needed to hear hers.

To be continued…

As a PS, I won’t be exclusively writing about my pregnancy from hereon forward. I’m just trying to catch everyone up to the present day so that you know how I’m doing and how the pregnancy is going.

Six Weeks and Six Days

Wednesday, October 17, 2012 – Thursday, October 18, 2012

I woke up the morning after finding out that I was pregnant to call my gynecologist. When the receptionist answered, I introduced myself and asked if she could relay a message to my doctor.

“What’s the message?” the receptionist inquired.

“Would you mind telling her that ‘I’m no longer in chemo menopause because I’m pregnant?’”

The receptionist was silent for several seconds so I interjected before it became uncomfortable.

“I bet you’ve never typed that message down before!”

We both laughed awkwardly before she replied, “No…I haven’t.”

When my gynecologist returned the call 30 minutes later, she expressed her shock and then said, “To be honest, no doctor is going to be able to tell you that you can or can’t carry safely to term. There’s not enough research about pregnancy and one of your health conditions, let alone any research that looks at pregnancy and all of your conditions.”

“I know. No one unfortunately has a crystal ball,” I responded.

“If you decide you’ll try to carry, you need to stop your migraine medicine immediately. That drug is highly toxic to a fetus.”

I knew that, but it was easier said than done. I’ve suffered from migraines since I was a teenager. The medicine I’ve taken since 2003 has been the only medicine that has worked and kept my migraines at a manageable two a week.

The rest of the day was spent preparing for my Health Activism and Social Media class that evening. The topic for the two-and-a-half hour class? Abortion.

I broke down several times as I worked on my Power Point for the lecture. During the class itself, I had to fight back the urge to tear up. There was a video that I showed from an anti-choice organization that included a sonogram photograph of an embryo at six weeks and six days. I was exactly six weeks and six days pregnant.

The following day, I headed to my gynecologist’s office for an ultrasound. I knew the technician because I had gone there the previous month for a sonogram because of menopausal pelvic pain. (Oh, the irony!)

As one would hope, the technician was extremely compassionate during the ultrasound. At that stage of development, the embryo just looked like a tadpole on the monitor. I exhaled when she informed me that the size looked good so far, but I started sobbing when I heard a noise and she commented, “Strong heartbeat.”

I looked up toward the ceiling and silently prayed. I didn’t think there was a chance that my doctors would let me try to carry to term, but I wondered what message God was trying to tell me.

To be continued…

Taking the Test

Tuesday, October 16, 2012

I left my friend at Starbucks with one thing on my mind:

Chicken Wings from TGI Friday’s.

I couldn’t remember the last time I ate chicken wings or went to Friday's. As I walked to 2000 Pennsylvania Avenue, I realized that I had been craving a lot of different foods over the past few weeks. I couldn’t get enough tofu, egg salad and chickpeas, and yet, I was passing on the beef dishes that I normally loved.

I wondered for a moment if I could be pregnant and reviewed the miniscule chances of that in my head:

  • The average 39-year-old woman has approximately a 7% chance of getting pregnant in a given month.
  • I was in full chemotherapy menopause for over a year. Even though my periods had returned, I was still experiencing some menopausal symptoms.
  • Chemotherapy increases the risk of infertility and damages eggs, especially in women who are in their 30s and had high doses of chemotherapy.

I ordered my chicken wings from the carryout counter and went across the street to CVS.  It was easy enough to pick up a pregnancy test for the peace of mind.

Fifteen minutes later, I headed home with my chicken wing sampler and the test.

After eating two wings, I went into the bathroom. I began to count the requisite seconds and before I had even reached, "Five Mississippi," the test was positive.

I stared at the test and started to scream and sob hysterically.

“Noooooooo! Are you kidding me? What are you doing to me, Lord?!?” I looked up at the ceiling and yelled. “”Why are the odds of this? What kind of cruel lesson am I meant to learn here?”

Why, given my desire to be a mom, did I react this way?

Well, between my chronic migraines and highly toxic migraine medicine, the fact that I wasn’t even two years out of treatment for breast cancer, and my genetic health conditions, I couldn’t imagine that my doctors would give the green light for me to even try to carry to term.

As sad as I was, I did my best to dry my tears. I’d call my gynecologist first thing in the morning. I couldn’t do anything else at this late hour so I just tried to relax and get some sleep.

To be continued with a thankfully much happier tone…

Miracles

“With your luck, you might want to stay away from lightening storms,” a doctor told me after reviewing my health history.

Such a comment might offend some people, but I just chuckled in response. I’ve long since accepted the fact that my health is unique. Several doctors have called me a medical anomaly. Some have said that there might be a journal article written about me in the future, and others have used the term, “miracle,” to describe my health.

Anytime I’ve been a “medical miracle,” it’s involved me dealing with an incredibly difficult health situation. A few examples:

“You’re the first patient with Guillain Barre to come into the hospital not on a gurney!” a doctor explained as I was admitted with ascending paralysis.

“You have an aggressive strain of cancer, but thankfully, it was caught early,” my oncologist informed me.

“When I opened your head, the nerves, tissues and muscles were all in the wrong places, but you have the right amount of everything!” my neurosurgeon said with surprise.

Moving to the present day, I've been hearing my doctors use the term, "miracle," a lot lately to describe my health situation. But, for the first time, there's no downside to defying medical odds.

This wasn’t supposed to be possible, and yet, it happened.

I’m 15 weeks pregnant.

How am I feeling? What do my doctors say? What are my thoughts on being pregnant? Will I still adopt?

I promise to get to all that and more.

For now, just know that I’m believing in miracles and humbly praying every day that all continues to go well until my due date on June 6, 2013.