Cancer and The Pursuit of a Baby

I used to hope for a sign from the Universe about whether my husband and I should have a child together. I got my sign. I just didn't know it would come in the form of Cancer.

When I met Kelly I told him I didn't think I ever wanted to have children. I was 27 and full of opinions. I couldn't find many examples of couples for whom becoming a parent made their marriage stronger. Sure, everyone said it changed them without question and gave purpose to their life in a way nothing else ever had. But I also saw the harsh reality; having children robs couples of the time and energy relationships need in order to be nurtured. So I was pretty firm that I didn't think it was for me.

Despite my reticence, after a few months of dating Kelly I found myself in a tough situation. I was in love with a man nineteen years my senior who had already done more living than I had dreamed about. He was a father to two young children and he was nearing fifty. I knew I had to ask his position on doing it one more time. Even though I wasn't sure I wanted to have children, I needed to know he wasn't against it. That would have been a deal breaker for me because it would have meant a finality that I wasn't ready to accept at such a young age.

"Do you think you are finished having kids?" I asked him while we stood inside the cramped bathroom of his temporary apartment. I tried to sound casual, focusing on my reflection in the mirror and the task of getting ready for work.

"Well," he said and then paused. "I can't say that I ever thought I would do it again. You know, because I've already done it. But I would never want to rob you of that experience either," he finished, trailing off.

That answer satisfied me.

Months turned into years and we grew together. I couldn't believe my good fortune at finding a man who cared so much about keeping our love alive, who was so committed to communicating about the hard stuff and who had taken the lessons of a failed relationship and become a better partner. I felt like I had won the love lottery. We knew what we had was rare and fragile. Something special to be handled with care. And so even with the passing of time, my reluctance to having my own biological child did not waiver.

Plus I had Riley and Keaton. We were very much involved in raising them given our shared custody. Half of our time was devoted entirely to feeding them, teaching them, coaching them, driving them, supporting them and loving them. I became a part of their lives before Keaton formed memories and was there through milestones big and small. So I was a parent already in every sense of the word. But our split custody meant that fifty percent of the time I was still just a couple.

That dynamic illuminated for me the reality of raising kids. And the reality is that it can be very tiring some times. That you give everything to these little humans and you don't have anything left for your partner. The neglect is born out of exhaustion, but it is still a slow wearing away of intimacy over time. We were different from many parents because every few days we had a couple of days without kids. That pendulum allowed us to continually nurture us, which in turn made us more involved, attentive and patient parents.

So do you see how I grew to be quite conflicted about having my own child?

Shortly after we married a few years ago I started thinking about what the future would hold for Kelly and me. If we continued on raising Riley and Keaton and balancing parenthood and marriage, in just under a decade we would be finished. Some may say we would be free. We would have successfully (fingers crossed!) raised two wonderful, college educated, responsible adults. And we could slow down. We could move to a smaller town where the pressures to have and to own and to impress are not nearly so heavy as Los Angeles. We could work less, take bike rides, read books, listen to music, have a garden, write, make delicious dinners, travel and spend our life living. We both started to fantasize about this a lot. We had lost enough people we loved to know that our time here is brief and fleeting and we wanted to spend it in the purist way possible as soon as we could. I loved this fantasy.

But it meant I would never experience pregnancy. Childbirth. The first scent of this person created out of love with the person I loved most in the world. It meant that this enormous experience that for many people IS the reason- I would not do that.

Lower down on the list was a fear of ending up alone at the end of my life. Above that was wanting to know what a Kelly and Meghan baby would be like- who they would grow up to be.

A few months before my husband was diagnosed with Cancer I was having dinner with a friend. She told me about a psychic she had met with who had a reputation for accuracy. I started fantasizing about calling her too. I had just one question- which path should I take? I daydreamed that I would not even have to tell her my quandary. She would predict it and more importantly she would tell me which road I was destined to take.

That summer my Kelly found out he had Prostate Cancer. As we sat in a sterile room at Cedars, an emotionless doctor told us his recommendation for treating it. Remove the prostate. The good news was that it would like kill the Cancer. The bad news- it would kill the chance for natural reproduction. And so all of a sudden, just like that my decision was taken away from me. Or made for me, depending on how you look at it.

But of course that is not the whole story. Because modern medicine provides us opportunities and access to possibilities that were once only a dream.

*****

When your husband who is youngish and healthy and otherwise giving aging the bird is suddenly diagnosed with the "C" word you tend to feel a bit like you were hit by a bus while crossing the street. The day after we received the news I remember driving and thinking over and over again that the test must have been wrong, something must have been mixed up. How could my husband have Cancer? But then we saw the pathology ourselves, slides containing microscopic segments of tissue taken from his prostate. They were rated on a scale of benign to holy shit and they were kind of a mixed bag of results. I obsessively stalked Google for guidance on our best course of action as I usually do when I find myself looking down the barrel of a particularly scary gun. Knowledge, facts, statistics and research provided me some comfort since I had no idea what I was embarking on.

What I found is that there is more than one way to treat Prostate Cancer. One option is active surveillance- basically watch and wait and cross your fingers that those nasty Cancer cells grow so slowly that something else kills you long before they do. Another, cut the Cancer out with a radical prostatectomy. Major surgery, risks of incontinence and impotence, high probability of eradicating the disease entirely. So, what might be castration, but at least my husband would be Cancer free! The last option was radiation seeds implanted in the prostate. Similar side effects to the surgery, similar effectiveness.

My husband's father died when Kelly was seven years old from Leukemia, a consequence of his exposure to radiation during atomic bomb testing when he served in the Navy. For Kelly, the radiation was not an option. Although his fear may have been misguided, I didn't think it was unfounded and so I didn't push. After weighing our options, seeking the advice of several urologists and hearing the stories of more friends who had Prostate Cancer than we could've imagined, we opted for active surveillance. Kelly would take daily medication, receive monthly blood tests and his Cancer would be closely monitored by his doctor. Otherwise life would continue on unchanged. We both liked this plan because it let us kind of put Cancer on a shelf and pretend it wasn't real.

Meanwhile, knowing my husband had Cancer brought the whole baby making question back into the spotlight. Now more than ever, I was acutely aware that he may not be able to fulfill his promise to live to one hundred years old and die beside me in a hospital bed a la The Notebook. My mind traveled to the darkest recesses of my imagination. I saw my future; widowed, childless, alone. That scared the shit out of me. But I did not want to respond to tragedy by ignorantly believing having a child would solve our problem. That seemed reactive and irresponsible. I did not want to embark on motherhood propelled by a fear of losing my husband and ending up alone. Being a parent is about unconditional selflessness, this seemed like a desperate grab for a life preserver. We talked a lot more about it and ultimately I agreed to quit taking the birth control pills I had religiously consumed for the past decade. We weren't going to try to get pregnant, but we weren't going to not try either. We kind of took a laissez faire approach to the Cancer and the baby making.

The winter of that year brought with it a number of tragedies, three to be exact. Over the span of several weeks our daughter found herself in the ER with pneumonia, our son contracted viral meningitis and was hospitalized for five terrifying days, and Kelly's mom passed away after a battle with dementia. Hospitals became our second home that January and I silently told myself the next time I was in one better be for something happy like a birth. As we counted our blessings for Riley and Keaton's improved health and simultaneously mourned the loss of Kelly's mother, his doctor was troubled by what his lab tests told him. The results were more concerning than he had anticipated. He blamed stress, my husband had been under more than most that month, and suggested we retest in two months.

Winter turned to spring and life carried on. We laid Kelly's mother's ashes to rest at a beautiful spot by the sea and began the long process of cleaning out her house. The Cancer was able to settle into the back of our psyche because it didn't show it's face in any of the regular ways. Kelly still worked out and played soccer, he felt great and looked great- it was easy to forget that it was there.

Kelly took me to breakfast on a warm day in May. We were reading the paper when his phone rang. It was his urologist. Calling on a Sunday. On Mother's Day in fact. The call was brief. The news bleak. His doctor had the pathology reread by an expert in the field- the Cancer wasn't a lazy as we had all been lead to believe. We had waited nearly a year and the disease had been given time to fester and grow. The doctor didn't want to wait any longer. He felt removing the prostate was essential. Quickly. He told us to plan for surgery in three weeks.

Three weeks. Riley would be graduating from middle school. Would Kelly be able to witness this moment? Three weeks. Didn't we need to freeze some sperm in case we wanted to try to conceive through fertility treatments? Three weeks. It felt too rushed. But then not rushed enough given we didn't know if and where the Cancer had spread during the last year.

We scrambled around. Making appointments for blood work and pre op tests and sperm analysis and freezing. My husband found himself inside a doctor's office nearly ever day for weeks. We had to tell the kids. We had shielded them from this news before. But now, a surgery meant it was real and we couldn't hide it. We sat around the dinner table like we did many nights. I was the one who said it. Kelly's eyes told me he was scared. I could be strong. We reassured them that this is treatable and has a very high survival rate. We tried to tell them what we wanted to believe, that daddy would kick Cancer's ass.

Keaton was too young to understand the implications of what we said. He believed us when we told him daddy was going to be just fine. Riley was fourteen at the time but with the soul of someone much older. She grew very quiet, I could see her gears spinning as she absorbed the news. She got up from the table and took her dish to the sink. I got up too and wrapped my arms around her.

"I'm not lying to you. He's going to be okay. I promise I wouldn't lie to you about this. It is a very treatable form of Cancer. He's going to be fine," I said.

Her eyes looked at me with doubt but slowly I watched her face change. I knew she trusted me and I believed the words I was telling her. I had spent hours researching this disease and I knew Kelly had a good shot at catching it early and putting this all in the past.

 In the few short weeks before surgery my husband visited a sperm bank twice. We chided ourselves for not preparing sooner. If we hadn't squandered our time he would have made endless deposits into the bank of our future child. But foolishly our ignorance had prevented our planning and we were given only two chances for our eventual baby making. If that is what we decided we wanted. In the hurricane of Cancer treatment planning, deciding if we wanted to become parents one more time kind of took a back seat.

Kelly's surgery was on a Wednesday morning in early June. It was performed by two surgeons and a robot, a modern advancement meant to reduce complications and minimize invasiveness. I spent the morning in the St. John's cafeteria with our close family friend, a nurse at that very hospital who had helped us find Kelly's doctors and ensured he was in the best hands. She helped take my mind off the runaway train of worries and concerns I had as my husband had an organ removed from his body. Four and a half hours after we parted his doctors arrived to tell us the surgery had been a success. The Cancer was confined to his prostate, they felt confident they had removed it all and certain that my husband would recover fully. The knot in my stomach unraveled a bit.

Because of our friend's connection with the hospital, she was able to sneak me back into the anesthesia recovery unit. The doctors had warned me that because of how he was positioned during the surgery his face would be swollen. The lines that usually etched his face, the lines that tell the story of the life he has lived were erased by his temporary swelling. He could barely open his eyes. And he didn't really know I was there. But getting to hold his warm hand in mine, seeing the monitors beep and blink reassured me that he was alive and that he was going to be okay.

He was transferred to a private room a short time later. I was able to crawl into the bed beside him and lay my head on his shoulder. I didn't want to be away from him. That night I slept on a little window seat in his room. I stared into the night sky and said a prayer of gratitude. I had spent my whole life hoping to find a love like ours. I wasn't ready to give it up so soon. I would never be ready.

*****

My husband's recovery was slow and frustrating for him at times. Against all odds, he made it to Riley's graduation. But it was months before he would begin feeling like himself again. In truth it was probably a year before he felt as recovered as he ever would. He had moments of doubt that getting the surgery was the right path; moments when it felt like they had taken more from him than his prostate. I knew regret was futile and I made it my mantra to help him see that too but it was a long journey to make peace with it.

It was nearly a year after surgery that Kelly and I had our first appointment with a fertility doctor. I had spent the last few months researching our options for reproduction. I knew we had two sperm collections and a body that although it still made sperm, it did not have a working method for letting that sperm escape from the body. We met with a male fertility specialist who gave us two unexpected surprises. First, our two samples were actually split into six vials which meant rather than getting just two shots at making a baby, we had six. We breathed a collective sigh of relief. The other gift was that even if we were not successful with the sperm we already had, there were methods available for retrieving more. Suddenly the clouds cleared on our chances of becoming parents.

Armed with this new information we visited a fertility specialist. She reviewed the viability of my husband's samples and told us with a big smile on her face that Kelly may very well earn the title of "Supersperm". His spermcicles responded very well after a long thaw and she felt our decision to attempt to get pregnant through insemination was reasonable. Insemination doesn't require the cost or surgical intervention of IVF and is essentially the fertility industry's answer to turkey basting to make a baby- we were on board.

The best chance at conception through intra-uterine insemination (IUI) involves a shitload of hormones and nearly daily ultrasound monitoring to ensure the procedure is timed just right to bring egg and sperm together. I was 35, had never been pregnant but had never tried to be and was otherwise healthy. Kelly didn't need our doctor to tell him that his baby juice was fertile, in so many words he told me it didn't take much to conceive Riley or Keaton. Armed with this information we felt attempting IUI without any drugs was a conservative first shot. The timing of the insemination fell right when we planned to go to San Diego for a summer vacation. My doctor advised we could do the procedure a day early, sometimes the sperm stay active for up to 48 hours in the body.

During our week long trip to the beach I felt certain the treatment had taken and I was pregnant. I laid my hand flat against my stomach as I fell asleep each night and dreamed about what the months ahead would be like. Even though I wouldn't know for two weeks if I was pregnant I still avoided alcohol and otherwise treated my body like the baby incubator I was sure it had become. As the days neared that we could test for pregnancy I felt bloated and crampy but different than when I had menstruated. On a Wednesday morning ten days after the insemination I woke up quite early. The sun hadn't risen but I could feel the familiar pang of my period. My lower body radiated with pain. I refused to get out of bed and go to the bathroom. I didn't want to face that it hadn't worked. When I finally sat down on the toilet I saw the blood that told me I wouldn't be a mom, at least not yet, and I cried.

I took a hot shower and came back to bed wrapped in a towel. I curled into my husband's warm sleeping body and I wept. He wrapped his arms around me and asked with alarm in his voice what was wrong.

"I'm bleeding. I'm not pregnant." My sobs shook my shoulders and he squeezed me tighter. He kissed the back of my neck and told me over and over again that it would be okay, that I would be okay. I knew he was right but at that very moment I was so very sad for what I had lost, something that I had never even had. I was hopeful and ignorant about how miraculous it is for life to actually form. I really thought we would be one of the lucky few who it worked for on the first try.

That night Kelly treated me to sushi and martinis, two things I had diligently avoided the last few weeks. We ate dinner in bed and relished in the time together. I made peace with our failed first try at conception and resigned myself to enjoy the next month and a half before we could try again.

I approached attempt two a bit less optimistic and a lot more realistic. I was willing to administer the injections of hormones to myself, willing to have an ultrasound wand probe me daily to track the development of my egg, willing to have what felt like gallons of blood drawn all in the name of getting pregnant. If I was blissfully optimistic the first time, I was neurotically over-prepared the second time. The hormones could give us twins or multiples my doctor warned. Fine we'll take our chances I responded. Twins wasn't what I was hoping for but neither was not getting pregnant at all so I crossed my fingers and injected the drugs into my belly each evening.

Kelly had been there to hold my hand during our first IUI but for the second round I insisted he needn't come. I was generally pessimistic that it would work and wanted to avoid all the pomp and circumstance I had required the first go round. This time, I wanted to remain as unattached to the outcome as possible. What would be, would be I told myself to guard against another disappointment.

The two week wait passed more quickly this time, I was engulfed in work matters, distracted by life. My doctor's office called me a few days before I was due to return for a blood test to determine if I was pregnant. They had noticed I hadn't made my appointment yet. I told her I was waiting to see if my period arrived. She pushed me to arrange a time to come in to test. I did so, begrudgingly.

The night before I was scheduled to return to my fertility doctor to find out if we had been successful I took a pregnancy test at home. I peed on the stick and distracted myself with my phone while I waited for my fate to appear in the window. Expecting nothing, I looked down and noticed two dark lines staring back at me. My heart skipped a beat but my excitement was tempered by the knowledge that all the hormones I had been taking could have given me a false positive. Despite this, I still felt a little jolt of electricity that I might actually be pregnant! I couldn't bear to tell any of my friends or my husband even though I was dying to. I was just too scared that the test had been wrong, a cruel twist on an emotional journey. I buried the test in the bottom of the trash can and pretended it wasn't real.

The next morning I had my blood drawn. This test would provide me undeniable proof that we would be parents one more time or that our efforts had failed again. The hours passed painstakingly slow, each time I looked at my phone willing it to ring, delivering my fate.

My doctor called a little after noon.

"Meghan, it's Dr. Chang. You're the first patient I wanted to call today. I have good news! You are pregnant! You're very pregnant! Your test results came back and they look wonderful! Congratulations!"

Tears sprang to my eyes at the sound of her news. All I could utter was, "I cannot believe it. I cannot believe it worked. I am so happy. Thank you. I am so happy!"