Giving Birth to Johanna While Facing Down Cervical Cancer
Pregnant and diagnosed with cervical cancer at age 27, I chose treatment and my daughter and I survived what experts said would kill us.
My cancer journey began in September 2013 just 5 and 1/2 months after the birth of our first child and 3 and 1/2 months after my last pap, but it would take me another eight months to be diagnosed. I began having severe pain in my lower abdomen and bladder area so I went to the doctor and was told it was most likely a urinary tract infection and put on antibiotics that were safe to take while breastfeeding. Turns out my son was allergic to them, so I was put on another and had to pump and dump for the next ten days. After that my son refused to nurse and shortly after I began spotting. Unsure as to why the sudden change I called my obstetrician’s office and they said it could be because of hormone changes since my son stopped nursing.
The spotting continued every day and seemed strange to me but I kept being told it can take several months for my hormones to balance out. At the beginning of February 2014 I told my husband that I thought I was pregnant. He didn't believe I could be since we had been using protection, and I had been bleeding so much. I knew it didn't make any sense that I could be pregnant but I still felt like I was. Then on February 8, I was at work and suddenly started gushing blood.
Shocked and scared, right away I knew I must be having a miscarriage. I was passing blood clots the size of my hand and soaking through a maxi pad and tampon within 5 minutes. I called my husband and he took me to the emergency room. I was told that my HCG was elevated so I was pregnant but going through a miscarriage. I was sent home and told to follow up with my obstetrician/gynecologist to get birth control to help regulate my hormones.
The hemorrhaging continued over the next month and I kept telling my husband and family that I thought I was still pregnant and that maybe it was a twin we had lost. On March 3, my husband took me to my obstetrician, and we told him everything that had been going on. He said to be safe he wanted to do an internal ultrasound to see what was going on. He completed the ultrasound and there was no baby on it but found that I still had pregnancy tissue in my uterus but he wanted to try and let it pass naturally and not do a D&C. I was sent home and told if the hemorrhaging didn't stop within two to three weeks to call him.
Needless to say, the bleeding never stopped or slowed down and the blood clots kept coming. Through all this I was extremely nauseous and definitely felt like I was pregnant still but didn’t think I was because I saw two ultrasounds that both showed I wasn't. Finally on March 26, I called my obstetrician and told him what was still going on and that all my pregnancy tests were coming back positive within ten seconds. He sent me to my local hospital for blood work. The next morning, I received a phone call from his nurse telling me that he wanted to see me right away. My husband left work and we began the two hour drive to Medford, Oregon where my obstetrician was. Once there I found out my HCG levels were 115,600 so he did another ultrasound, only this time to find out I was actually still pregnant and about 11 weeks along.
The same ultrasound revealed that I had a softball-sized cyst on my left ovary and a small tear in my uterus (believed to have happened when I miscarried the twin) called a sub chorionic hemorrhage that was causing my bleeding. I was so relieved to finally have an answer to everything but was terrified of losing my baby due to this hemorrhage.
By now it was April and my son was turning 1. We had an amazing birthday weekend for him, and I was able to celebrate my pregnancy with family and friends. By April 7, I was put on modified bedrest when the bleeding continued and the pain got worse. By now I was unable to keep up with my 1-year-old, so my almost 10-year- old son had to help me do almost everything with him while my husband was working.
Afraid to lose my pregnancy so far into it, I kept returning to my obstetrician about every other week complaining of the unusual pain in my abdomen. I was told that since I had just had a Caesarean section the year before, I wasn't fully healed. I ended up going to two different emergency rooms on two separate occasions because the pain was so intense. By June I was only sleeping about 1-2 hours a night because of the pain and bleeding. At 19 weeks pregnant I remember feeling an enormous amount of pressure making me believe that the baby was down low and that I would be delivering soon. My husband took me back to Medford and we met with my doctor first thing in the morning. He did a pelvic exam and believed the baby was being born and rushed me over to labor and delivery. Once there I was given an ultrasound only to find out that the baby was healthy and not being born. It was at this time my husband and I found out that we were having a little girl and we named her Johanna. Our excitement was short-lived when the ultrasound tech found a huge mass in my cervix. After several more ultrasounds, exams and a biopsy, it was confirmed that I had cervical cancer.
Pregnant With Aggressive Cervical Cancer
So my journey as a cancer patient while pregnant began, and the first decision I was told I needed to make was whether or not to keep the pregnancy. I was told that I had a very aggressive form of adenocarcinoma cervical cancer (this was not caused by HPV and I never tested positive for it). Due to how fast it was growing and spreading, I would not be able to survive the pregnancy if left untreated, and treatments would kill my unborn daughter.
The doctors decided they were going to send me to OHSU in Portland to see the gynecologic oncologist there. Next was trying to stage the cancer which is normally done by a CT/PET scan but those are harmful to the fetus, so I could only do a chest x-ray and an MRI to stage. The next day, I met with one of the top gynecologic oncologists, and she told me that as aggressive as the cancer was there was no way for my daughter to survive and that I needed to begin treatments right away.
I was given two options: one was to perform a radical hysterectomy; the other was to start chemotherapy/radiation and the radiation would poison and kill my daughter. I was now faced with a devastating decision on whether to try to save my daughter or myself. The doctor urged me to think about my young sons at home and how much I was needed but all I could think was I couldn't sacrifice my daughter's life for my own. With our pastor and our parents we all held hands and prayed. We prayed for a miracle and for God's will to be done. About 10 minutes later the oncologist came back with another oncologist she had been consulting with, and she said, "we have a new option: to send you to Portland and begin experimental chemotherapy to shrink the tumor enough to safely deliver your daughter and then begin normal treatment.”
I was beyond excited and everyone in the room knew God had given us the miracle we asked for. The change in plans was because my cancer was much more advanced than previously thought. After looking at the MRI results, it was clear that any attempt to deliver my daughter now would spread the cancer and radiation would not shrink the tumor fast enough, killing her and causing serious health issues for me. The tumor was already 9x9x7 cm in less than 1 year.
My husband and I flew to Portland the next day and were met at OHSU by four teams of specialists that had been put together for my daughter and I. We had the gynecological oncologists, radiation oncologists, perinatal high-risk obstetrician team, and the neonatal team who would all be following me on this experimental chemotherapy journey. My gynecologic oncologist was very upfront with us from the beginning and let me know he had never seen this aggressive of a type of cervical cancer in a pregnant woman before, and there was a chance the treatments would not work. I decided that I wanted to try anyway. I was diagnosed with cancer on June 3 at the age of 27 and began my first round of chemotherapy on June 6.
I was given a very aggressive treatment of cisplatin and paclitaxel. I was told I would lose my hair within a couple of weeks and that this was not going to be easy. I was informed there was very little information on paclitaxel administered during pregnancy and that it could harm the baby. Nobody knew for sure since it's not a common practice. I decided to go ahead with the experimental chemotherapy because I felt that I was at least giving my daughter a chance at life if I tried this and it worked. Two weeks after my first round of chemotherapy, the hemorrhaging stopped. It had been 8 long months of bleeding. This was when I knew the treatments were beginning to work!
My mom started a prayer page the day I was diagnosed with cancer to help get prayers, to inform our friends and family of how we were doing, and to keep them updated. I took over this page and began providing updates but always kept positive and let people know how blessed we were. By Sunday my good friend and hairdresser along with her husband made the 8-hour drive to surprise me in the hospital. We decided to cut my hair which was pretty long and give me a cancer makeover.
The nurses kept coming into my cancer suite to meet me and hear about my story and I kept hearing how they had never met someone who had such a positive outlook after being diagnosed with cancer. I had made up my mind that week that I would never let myself be a victim and that I would never let my boys see me get depressed. I knew in my mind that I would beat cancer and be there for my kids.
Hope for Two and a Grueling Regimen
After a week in the hospital I was released and allowed to go home. Over the next 2 months I would come back to Portland for chemotherapy every 3 weeks. With each round of chemotherapy, I would check into the hospital for 2 to 3 days and have a full check up on Johanna with tests and ultrasounds and then begin chemotherapy, usually followed by a blood transfusion and magnesium drip. By my second round of chemotherapy I had lost all my hair and was rocking the bald look. Although I tried to have a positive outlook, I never shared how difficult the journey really was on the prayer page.
The chemotherapy made me extremely weak, tired and nauseous. I was unable to eat and would force myself to drink Ensure shakes knowing I had to take in some nutrients for the baby. I needed help with simple tasks such a taking a shower and could still only do that if I was sitting down. I was so weak that after taking a shower I would then sleep for another couple of hours. I lost a total of 27 pounds during my pregnancy. I was missing out on so much of my boys’ lives and felt so bad but I knew if I could just make it through all this everything would be worth it. I met with the perinatal high-risk obstetric team, and they decided that they would deliver Johanna at 32 weeks gestation to give us both the best chance. The tumor had already spread into my uterus and she was sharing space with it. Each time she kicked or hit it, I was put into intense pain.
Back at home, my family had spread the word through our small community and started some fundraising to help us with bills and medical expenses since I was on disability, and my husband took time off to be with me. Our community was amazing and such a huge support system. It was then that I learned about Hope for Two and requested to be connected with a support woman.
I spoke with her regularly about treatments and what to expect. Although my support woman didn’t go through chemotherapy while pregnant, she was very helpful and supportive. On July 19, I was able to attend a relay for life event at 25.5 weeks pregnant, bald, in a wheelchair and with about 80 people all wearing Team Davis t-shirts! It was such an uplifting experience that made me want to fight that much harder. Once I got to 28 weeks gestation, the perinatal team said they were going to treat my pregnancy as though I was 36 weeks and do everything they would the last month of pregnancy.
I began having weekly visits with a high-risk obstetricsl team in Medford in between visits to Portland. My fourth and final round of chemotherapy while pregnant was scheduled for August 11 at 29 weeks gestation. I wasn't feeling good at all that day and noticed I had gained 4 pounds over the weekend which was odd since I had lost 25 pounds since becoming pregnant. The doctors ran several tests for preeclampsia since I had previously had it with my son. I was told that I did not, but they believed that I was at borderline for the condition and they wanted to keep an eye on it. My daughter, however, was not passing her non-stress tests, at first causing a lot of worry that they needed to deliver right away. After 12 hours of testing they determined it was safe to start the last round of chemotherapy while pregnant.
Johanna Arrives—Ahead of Schedule
The next week I had an appointment in Medford with the perinatal team. About an hour after arriving, my water broke at 30 weeks and one day. My husband took me to labor and delivery where I was examined. They determined that Johanna was healthy and that there was no amniotic fluid left. They gave me the first of two steroid shots to try and mature Johanna's lungs and then gave me medication to try and stop my labor. I was then airlifted to Portland and met by my perinatal team.
Once in Portland my labor began progressing much more quickly than expected and Johanna was delivered via emergency Caesarean section on August 20 after starting to be born breech. She weighed 2 pounds, 10.3 ounces and was 16.1 inches long. She was able to breathe on her own with just the help of a C-pap machine and room air even though she didn't get the second dose of steroids before delivery. She was doing amazing and passing all her tests, not showing any side effects from the chemotherapy.
Two weeks after delivery, I began the next phase of treatments. I had five more rounds of chemotherapy, this time every week along with 25 radiation treatments and five internal radiation treatments. Finally, on October 6 after 47 days in the NICU, Johanna was able to leave the hospital and come home with us to the Ronald McDonald House where we had been staying. I had not finished my treatments, yet so we were still staying in Portland.
My parents would bring our boys up to see us every other weekend while I was going through my second phase of treatments. On October 27, which ironically was Johanna's due date, I finished my last internal radiation and was able to begin my journey home after 10 long weeks of being away. Coming home for the first time with my baby girl and two boys was the most amazing feeling in the world. My daughter and I had just survived what the experts said would kill us, yet here we were, alive and kicking. On February 11, 2015 after several months of tests and a CT scan, it was confirmed that I am in remission and that I had kicked cancer's butt.
Johanna is doing amazing as she turned 1 year old in August and is reaching all her milestones, many ahead of when the neonatal doctors thought she would. I am happy to say that my husband and I, along with our kids, are enjoying life and taking advantage of every opportunity we get to spend quality family time together. As I begin recovery, we are looking forward to seeing what the future holds. I am very thankful to Hope for Two for showing me that I was not alone and that other women have gone through chemotherapy while pregnant and can share successful stories as well.