Wednesday, December 09, 2015

So I'm going to be a dad

“So guess what? I’m not the only one in this couple with a mysterious growth inside me!”

That’s how I considered telling my parents and parents-in-law that we were expecting a child at the same time I was battling cancer. But that’s not how it happened.

Instead I was lying in my hospital bed with my wife Melanie holding my hand. I was still groggy as I recovered from a biopsy and had a great big tube coming out my side to drain my chest. Days earlier a mysterious lump had been found in my upper chest, and while we waited to find out what it was we all feared the worst.

It happened to be my birthday and I was happily receiving gifts from the people gathered around the bed. It came time for Melanie to give me a present, and she handed me one that she’d very carefully selected – a book, “So You’re Going to Be a Dad”.

I enthusiastically unwrapped it and held it up for my parents and parents-in-law to see. As I began to utter the magical words waves of emotion lashed the shores of my mind. “It’s been a pretty eventful few days,” I said, my voice rising an octave. “Well, Melanie and I have some more news for you. We’re going to have…” My sobs overwhelmed the end of the sentence.

After some frantic pointing at the book and at Melanie’s belly the meaning of my curtailed revelation was clear. With infectiousness suitable for a hospital, we all quickly teared up and exchanged hugs. Even my father, not known for public displays of emotion at places other than the Southern Stand of the MCG, was soon in need of a box of tissues.

Melanie and I knew we were expecting a baby since before my health troubles emerged in mid-October but told few people until the first anniversary of our wedding on Monday. It’s a relief to finally share the information, meaning we no longer need to keep a big secret amid all the tumult.

So what does it mean to have a pregnancy and a cancer battle going on in the one household at the same time?

For starters, we’ve got to be careful. When you take chemo drugs, and for a week after, the patient is cytotoxic, meaning their secretions are poisonous (literally “toxic to cells”). Most other people have robust enough immune systems to cope with small amounts of cytotoxic exposure, and the only concern is significant spills of bodily fluid. But for a developing foetus, cytotoxicity can do damage to development, particularly during the first trimester. (I started chemotherapy when Mel was 11 weeks pregnant.)

After speaking to several doctors on the oncology and obstetrics sides, we decided to take a very cautious approach.

One recurring piece of advice was to use separate toilets – but our modest one-bedroom home has just one. To the rescue came Mel’s dad Keith, a fine father-in-law and an excellent home handyman. He quickly formulated a plan to construct a temporary dunny on our veranda. Within days he’d got the materials he needed at Bunnings and set to work. Before long we had a thunderbox to be proud of, fully flushing, walled in on all sides, and decorated with a tasteful landscape scene on the door. Our toilet problem had been solved.

Then there are all the other ways two people might incidentally pollute each other. The night sweats that had become common for me meant we opted for separate beds, with me sleeping in the living room. The shower was another potential hot spot, so Mel agreed to use other facilities available to her. We invested in a set of cutlery and crockery, with a distinctive design, so that we could each have our own utensils.

Six weeks after we started, it seems to be working pretty well. We’ve got into a happy rhythm at home and we know what we can and can’t do. For about one week in three, when the chemo drugs are flushed out of my system, things get back to normal, and for the rest of the time we just get on with it.

There’s not a lot of research about people in our circumstances. It is hard to know the exact risk posed to a foetus from exposure to cytotoxic chemicals, because it doesn’t happen very often. But the downside of being too cavalier seems far greater than the downside of being too cautious, so we are being careful. I would hate to be haunted by thoughts of “if only” if something unexpected were to happen. Still, some recent research showed that women who were diagnosed with breast cancer while they were pregnant could still receive chemotherapy beyond the first trimester without harming the foetus, giving us greater confidence.

My chemo and Mel’s pregnancy has had some similar effects on our bodies. Both of us are frequently and profoundly tired. Some days in the past few weeks when we get home it’s been a race to see who gets the couch and who gets the bed for a good lie down. The hard work each of our bodies is doing in response to the new arrival is sapping our energy and leaving little room for discretionary effort. We are also frequent visitors to the loo as our bladders struggle with the extra pressure – lucky we’ve got two (toilets that is, but it also applies to bladders).

Then there are the dietary changes. Both a foetus and a cancer patient during the neutropenic phase have a weak immune system and so are unable to fight off things that are innocuous for most others. So soft cheeses are out, as are unpeeled fruit, raw eggs, cold meats, some seafood and unwashed salads. Having the two of us both face the same restrictions on diet does make shopping and cooking a whole lot easier, although the things we do end up preparing are unlikely to land us a spot on MasterChef. (Though a MasterChef Preggers and Cancer special would be worth watching.)

Perhaps the toughest part is that neither of us are equipped to play the caring role we wish we could play. The advice for pregnant women is to seek support from their partners, and cancer patients get told a similar thing. Put the two of us together, though, and there’s a surfeit of care needed but a deficit available. Which is why we’re so lucky to draw on support from the aforementioned parents and parents-in-law, as well as dozens of others who have lent a hand.

If things go to plan I’ll finish my chemo treatment and enter remission in April, and Melanie will give birth in May. There’s a gap of just a couple of weeks, and if my treatment runs long or the baby comes early, we’ll have an awkward overlap. Tough if it happens, but we’ll cope. Also tough will be the few months beforehand, when the advanced state of Mel’s pregnancy might leave her exhausted, while the cumulative effect of my chemo will drain me of energy. All while we seek to prepare our house for the new arrival. Oh joy.

A few people have commented that the impending arrival of a child has given me extra incentive to beat the disease. Maybe. Even without a child on the way I had a strong will to live. There were too many interesting things out there to experience to allow me to shuffle into the sunset at 33 without feeling like I’d missed out. The prospect of becoming a parent – perhaps the most exhilarating things one can possibly experience – has given me something profound to look forward to.

But now I’m not just responsible for me. There’s a 17-week old foetus in Melanie’s belly that is depending partly on us to raise it, to feed it, to protect it and to tell it lame jokes. I have an obligation to be in this child’s life and help shape its identity. To lose the struggle against my disease would not just be a personal tragedy but would mean I did not fulfil my responsibility to another person. That is something I could not bear.

And so we battle on. A few weeks back we reached a milestone, when the mysterious growth inside Mel’s body grew larger than the mysterious growth in mine. As the months pass I look forward to seeing Mel’s expand, kicking playfully against her abdomen, as mine slowly shrinks. And by the time hers is ready to leave her body, I hope that mine has left my body as well. I can’t wait for the three of us to stare into the future, happy, healthy and together.

A few subtle differences between our wedding day and our first anniversary on Monday.

4 comments:

veritas said...

from a fellow canberra cancer folk - go you guys! it's funny, but i've had a few chats with pregnant friends about the process of pregnancy and cancer, and often they understand what i'm going through, and i understand what they are. i've often made the joke that cancer is the 'anti-pregnancy'.

good luck, and i hope you graduate in April with excitement! (and if you're at TCH, i might see you wandering around some time).

Angela Clare said...

Lovely words Ari. What a roller coaster you guys are on. If anyone can come through all this with grace and laughter, and stronger than ever, it's you two. Wishing you all the best

Sarah said...

I was diagnosed at 22 weeks pregnant with advanced cancer. I underwent chemo with baby on board for 3 months before our healthy baby boy was born and then continued for another 3. It was a very tough time but we got through. Unfortunately, I got to 8 months post baby before I was diagnosed again. My battle still continues. Wishing you and your family all the best. X

Jase said...

Best of luck to the whole family.